Does hypopharyngeal–esophageal multichannel intraluminal impedance–pH monitoring for the diagnosis of laryngopharyngeal reflux have to be 24 h?

Purpose To investigate the diagnostic value of combined multi-timepoint salivary pepsin testing (MTPSPT) and hypopharyngeal–esophageal multichannel intraluminal impedance–pH monitoring (HEMII–pH) for laryngopharyngeal reflux (LPR) and whether an appropriate reduction in the duration of HEMII–pH would affect the accuracy of diagnosis of LPR. Methods Recruited patients were studied with both MTPSPT and HEMII–pH. The diagnosis of LPR was based on the occurrence of > 1 reflux event and/or positive results on any of the MTPSPT. The diagnostic value of combined diagnosis was studied through combining a breakdown of the 24-h HEMII–pH finding and the results of the MTPSPT. The diagnostic value was expressed in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results Based on 24-h HEMII–pH and MTPSPT, the positive rate of LPR was 83.33% and 74.69%, respectively. According to the combined diagnosis, the positive rate of LPR was 90.74%. The sensitivity and specificity of the combined diagnosis both were 89.51% and 100%, when the HEMII–pH intervals were 7 a.m.–6 p.m. and 7 a.m.–7 p.m., respectively. However, when the monitoring time was extended to 8 p.m. and bedtime, the sensitivity, specificity, PPV and NPV of the combined diagnosis both were 100%. Conclusions The combination of MTPSPT and HEMII–pH increased the sensitivity and accuracy of diagnosis of LPR. For patients with positive MTPSPT results, the duration of HEMII–pH can be appropriately shortened to reduce patient sufferings.