Laringofaringeal reflünün nazal direnç üzerine etkisinin araştırılması
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turgut Özal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş-Amaç: Laringofaringeal reflü (LFR)'nün nazal konjesyon ve nazal direnç üzerine etkisini değerlendirmek; tedavi ile bulgulardaki değişikliği incelemek amaçlanmıştır. Gereç-Yöntem: Tipik gastroözofageal reflü (GÖR) yakınması ile gastroentoroloji kliniğine başvuran, özofagogastroduodenoskopi sonucunda alt özofagus sfinkter (AÖS) gevşekliği ve Los Angeles kalsifikasyonuna göre evre B veya C özofajit saptanan 164 hastaya, ekstraözofageal semptom sorgulaması içeren Reflü Semptom İndeksi (RSİ) anketi ve fleksibl nazofarengolarengoskopi ile Reflü Bulgu Skoru (RBS) değerlendirmesi yapılarak, RSİ skoru 13'ün, RBS skoru 7'nin üzerinde olan 50 hasta çalışmaya dahil edildi. Çalışma grubuna nazal semptomlardaki değişikliği değerlendirmek amacıyla NOSE (Nasal Obstruction Symptom Evaluation) anketi yapıldı. Sağlıklı gönüllülerden oluşan 50 kişi kontrol grubuna alındı. Çalışma ve kontrol gruplarının aktif anterior rinomanometri yöntemi ile total nazal direnç (TND) ölçümleri yapıldı. 12 hafta süreyle günde iki kez pantoprazol tedavisi verildi. Tedavi öncesi ve sonrası tüm ölçümler tekrarlandı. Elde edilen tüm veriler SPSS (Statistical Package for Social Sciences, SPSS 15.0; SPSS Inc., Chicago, IL, USA) programı ile değerlendirildi. Bağımlı grupların kıyaslanmasında Wilcoxon testi kullanıldı. Bağımsız grupların analizinde Mann Whitney testi kullanıldı. P<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Tedavinin 1 ve 3. ayındaki RBS, RSİ, total nazal direnç (TND), NOSE değerleri karşılaştırıldığında her bir değişkenin tedavi sonrasında istatistiksel olarak anlamlı bir şekilde düştüğü saptanmıştır (p<0,001). Tedavi öncesi TND median değeri 0,29 iken, tedavi sonrası 0,19 olarak hesaplanmıştır. Kontrol grubunun median TND değeri 0.20 bulunmuştur. Tedavi öncesi TND değerleri kontrol grubundan anlamlı derecede yüksek iken (p<0,001), tedavi sonrası kontrol grubu ile benzer olduğu tespit edilmiştir. (p= 0.226) Tartışma ve Sonuç: Reflü'nün sinonazal mukozaya etkisi son yıllarda tartışılan ve randomize kontrollü çalışmalarla fizyopatolojisi aydınlatılmaya çalışılan bir konudur. Bu çalışma, LFR'nin nazal direnç ve nazal konjesyon üzerine negatif etkisi olduğunu ve tedavi ile bu etkilerin düzeldiğini göstermektedir.
Objectives: To study the rhinologic impacts of laryngopharyngeal reflux, the effectiveness of treatment and objective evaluation of nasal resistance. Subjects and Methods: Patients with typical gastroesophageal reflux symptoms had undergone esophagogastroduodenoscopic examination. 164 patient has a result of, lower esophageal sphincter dysfunction and grade C or D esophagitis according to Los Angeles classification. Reflux Symptom Index(RSI) questionnaire were assessed to evaluate extraesophageal symptoms. Reflux finding score (RFS), were assessed to evaluate laringeal morphologic changes. 50 subjects whose RSI score above 13 and RFS score above 7 were included in study group. NOSE (Nasal Obstruction Symptom Evaluation) were assessed to evaluate nasal symptoms in study group. 50 healthy volunteers included in control group. Both groups' total nasal resistance (TNR) measurements were performed by active anterior rhinomanometry technique. Antireflux medicaton was given for 12 weeks. All parameters calculated before and after medical treatment. Statistical analysis was performed by SPSS (Statistical Package for Social Sciences, SPSS 15.0; SPSS Inc., Chicago, IL, USA). Dependent groups were compared with wilcoxon test and independent groups were analysed with Mann Whitney test. p<0.05 was considered statistically significant. Results: All parameters showed a significant decrease after treatment (p<0,001). TNR before treatment was 0.29 whereas TNR after treatment was 0.19. Median total nasal resistance (TNR) of control group was 0.20. Before treatment TNR scores was higher than control group (p<0,001) since it was similar after treatment (p= 0.226). Discussion and Conclusion: The impact of reflux on sinonasal mucosa has been a discussion point since there is no clear evidence to explain pathophysiology. In this study we express that LPR has a negative effect on nasal resistance and nasal congestion. Treatment will improve subjective and objective findings
Objectives: To study the rhinologic impacts of laryngopharyngeal reflux, the effectiveness of treatment and objective evaluation of nasal resistance. Subjects and Methods: Patients with typical gastroesophageal reflux symptoms had undergone esophagogastroduodenoscopic examination. 164 patient has a result of, lower esophageal sphincter dysfunction and grade C or D esophagitis according to Los Angeles classification. Reflux Symptom Index(RSI) questionnaire were assessed to evaluate extraesophageal symptoms. Reflux finding score (RFS), were assessed to evaluate laringeal morphologic changes. 50 subjects whose RSI score above 13 and RFS score above 7 were included in study group. NOSE (Nasal Obstruction Symptom Evaluation) were assessed to evaluate nasal symptoms in study group. 50 healthy volunteers included in control group. Both groups' total nasal resistance (TNR) measurements were performed by active anterior rhinomanometry technique. Antireflux medicaton was given for 12 weeks. All parameters calculated before and after medical treatment. Statistical analysis was performed by SPSS (Statistical Package for Social Sciences, SPSS 15.0; SPSS Inc., Chicago, IL, USA). Dependent groups were compared with wilcoxon test and independent groups were analysed with Mann Whitney test. p<0.05 was considered statistically significant. Results: All parameters showed a significant decrease after treatment (p<0,001). TNR before treatment was 0.29 whereas TNR after treatment was 0.19. Median total nasal resistance (TNR) of control group was 0.20. Before treatment TNR scores was higher than control group (p<0,001) since it was similar after treatment (p= 0.226). Discussion and Conclusion: The impact of reflux on sinonasal mucosa has been a discussion point since there is no clear evidence to explain pathophysiology. In this study we express that LPR has a negative effect on nasal resistance and nasal congestion. Treatment will improve subjective and objective findings
Açıklama
Tıp Fakültesi, Kulak Burun Boğaz Ana Bilim Dalı
Anahtar Kelimeler
Kulak Burun ve Boğaz, Otorhinolaryngology (Ear-Nose-Throat)
