{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:15:13Z","timestamp":1734066913589,"version":"3.30.2"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is currently no reference standard test for the detection of the extra\u2010esophageal manifestations of gastroesophageal reflux disease (GERD). The current suite of diagnostic tests principally assesses reflux events in the esophagus. A new scintigraphic technique has been developed and validated against reference standards. It allows direct visualization of refluxate in the laryngopharynx and lungs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty patients were assessed by scintigraphy before and after fundoplication at a single nuclear medicine facility. Standardized reflux symptom\u00a0indices (RSIs) were obtained from each patient before and after surgery. Patients were scanned after oral 99\u2009m technetium Fyton administration with early dynamic images and delayed SPECT\/CT images of the head, neck, and lungs. ANOVA, Spearman correlation, and the Student's <jats:italic>t<\/jats:italic>\u2010test were utilized for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population (35F, 15\u2009M) had a mean age of 63.9\u2009years. Mean BMI was 26.8 with 67% being overweight or obese. All patients had significant reflux. SPECT\/CT showed LPR events in 45\/50 and pulmonary micro\u2010aspiration (PMA) in 45\/50 preoperatively and in 36\/50 and 20\/50 postoperatively, respectively. The RSI, cough, and throat clearing indices showed a significant fall postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Frequency of scintigraphic reflux events was reduced from a mean of 4.5 in 30\u2009min to 2.9 (<jats:italic>t<\/jats:italic>\u2009=\u20099.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The novel scintigraphic test detects esophageal and extra\u2010esophageal reflux events and permits direct visualization of refluxate in the head and neck structures and lungs. It correlates well with symptoms of reflux in the esophagus and extra\u2010esophageal structures and the response to therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Although prospective, the study did not randomize patients and in effect each patient became their own control following an intervention (fundoplication). Thus, the study is Level 3 evidence <jats:italic>Laryngoscope<\/jats:italic>, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31748","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T06:40:46Z","timestamp":1725000046000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scintigraphic Imaging of Extra\u2010Esophageal Manifestation of Gastresophageal Reflux Disease"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4184-3330","authenticated-orcid":false,"given":"Hans","family":"Van der Wall","sequence":"first","affiliation":[{"name":"CNI Molecular Imaging &amp; Notre Dame University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia","family":"Burton","sequence":"additional","affiliation":[{"name":"CNI Molecular Imaging &amp; Notre Dame University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Cooke","sequence":"additional","affiliation":[{"name":"CNI Molecular Imaging  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory L.","family":"Falk","sequence":"additional","affiliation":[{"name":"Concord Hospital &amp; University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Tovmassian","sequence":"additional","affiliation":[{"name":"Concord Hospital  Concord New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James J.","family":"Conway","sequence":"additional","affiliation":[{"name":"Glenview  Glenview Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-304269"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70025-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2014.20.1.87"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(00)01071-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00097-8"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.02.001"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314722"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1675-y"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1479-666X(06)80063-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.125760"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01437.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.08.012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.4274\/mirt.galenos.2019.30085"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.4274\/mirt.10438"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i12.3619"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10353-016-0385-5"},{"key":"e_1_2_6_19_1","first-page":"342","article-title":"Findings from a novel scintigraphic gastroesophageal reflux study in asymptomatic volunteers","volume":"10","author":"Burton L","year":"2020","journal-title":"Am J Nucl Med Mol Imaging"},{"key":"e_1_2_6_20_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1179\/1066981712Z.00000000025","article-title":"Challenges with diagnoses: sketchy reference standards","volume":"20","author":"Cook C","year":"2012","journal-title":"J Man Manip Ther"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyi105"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2022.04.003"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/646901"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.18.0207"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200206000-00016"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2021.0046"},{"key":"e_1_2_6_27_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s10353-020-00632-5","article-title":"How effective is the control of laryngopharyngeal reflux symptoms by fundoplication? 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Toronto Canada.2024."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31748","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T06:40:51Z","timestamp":1725000051000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31748"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":39,"alternative-id":["10.1002\/lary.31748"],"URL":"https:\/\/doi.org\/10.1002\/lary.31748","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2024,8,29]]},"assertion":[{"value":"2024-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}