{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:51:55Z","timestamp":1770749515518,"version":"3.50.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T00:00:00Z","timestamp":1397001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gastroesophageal reflux (GER) contributes to periprosthetic leakage after prosthetic voice rehabilitation. However, underlying mechanisms are unclear, and markers predicting anti\u2010reflux therapy response are missing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed epithelial\u2013mesenchymal transition in 148 consecutive biopsies from 44 patients with\/without fistula enlargement under dual\u2010probe pH monitoring before and after proton\u2010pump inhibitor (PPI) therapy applying immunohistochemistry. Results were correlated with reflux intensity and clinical and histologic findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Epithelial\u2013mesenchymal transition correlated with GER in all samples, and patients with fistula enlargement showed higher epithelial\u2013mesenchymal transition scores. Contrary to patients without enlargement, epithelial\u2013mesenchymal transition scores did not regress during therapy in this group. Furthermore, pretherapeutic epithelial\u2013mesenchymal transition scores were lower in therapy responders than in nonresponders without reaching significance (<jats:italic>p<\/jats:italic>\u2009=\u2009.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate that epithelial\u2013mesenchymal transition correlates with severity of GER and presence of periprosthetic fistula enlargement in patients who underwent prosthetic voice rehabilitation, but epithelial\u2013mesenchymal transition seems to be reversible upon PPI treatment in early stages only. \u00a9 2014 Wiley Periodicals, Inc. <jats:italic>Head Neck<\/jats:italic> <jats:bold>37<\/jats:bold>: 530\u2013536, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.23622","type":"journal-article","created":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T10:59:02Z","timestamp":1392634742000},"page":"530-536","source":"Crossref","is-referenced-by-count":15,"title":["Role of reflux\u2010induced epithelial\u2013mesenchymal transition in periprosthetic leakage after prosthetic voice rehabilitation"],"prefix":"10.1002","volume":"37","author":[{"given":"Kai J.","family":"Lorenz","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery Bundeswehrkrankenhaus Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Kraft","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Bundeswehrkrankenhaus Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Graf","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Bundeswehrkrankenhaus Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Pr\u00f6pper","sequence":"additional","affiliation":[{"name":"Institute of Anatomy and Cell Biology, University of Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konrad","family":"Steinestel","sequence":"additional","affiliation":[{"name":"Bundeswehr Institute of Radiobiology Munich 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