{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:09:02Z","timestamp":1789416542584,"version":"build-2803163510"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Laryngopharyngeal symptoms (LPS) present a diagnostic challenge due to the lack of clear diagnostic gold standard, and suboptimal correlation between traditional esophageal reflux criteria and pharyngeal reflux events. Mean nocturnal baseline impedance (MNBI) is a measure of mucosal integrity that correlates with reflux burden, but evidence for its role in diagnosing laryngopharyngeal reflux disease remains limited. We aimed to characterize the correlation between MNBI and pharyngeal reflux on objective reflux monitoring. This was a retrospective study of adults with LPS undergoing reflux monitoring with hypopharyngeal-esophageal multichannel intraluminal impedance and pH. MNBI was calculated by taking the mean baseline impedance of three 10-minute time periods at rest (1\u00a0AM, 2\u00a0AM, 3\u00a0AM) from the distal electrode pairs (9\u201311\u00a0cm\/11\u201313\u00a0cm below the upper esophageal sphincter). Increased pharyngeal reflux was defined as \u22652 events in 24\u00a0hours per established criteria. Univariate, multivariable, and receiver-operating characteristic (ROC) curve analyses were performed. One hundred nineteen patients were included (mean age\u2009=\u200955.5\u2009\u00b1\u20091.4\u00a0years, 71.4% female). MNBI inversely correlated with pharyngeal reflux events (r\u2009=\u2009\u22120.25, P\u2009=\u20090.009) and was lower in patients with increased pharyngeal reflux (1867\u2009\u00b1\u2009124\u00a0\u03a9 vs. 2540\u2009\u00b1\u2009177\u00a0\u03a9, P\u2009=\u20090.0027). On multivariable analysis, MNBI remained independently predictive of increased pharyngeal reflux (OR: 0.94 per 100\u00a0\u03a9 increase, 95% CI:0.90\u20130.98, P\u2009=\u20090.008). On ROC analysis, the area under ROC curve for increased pharyngeal reflux was 0.65, with MNBI thresholds of 1017\u00a0\u03a9 and 3474\u00a0\u03a9 achieving &amp;gt;90% specificity and sensitivity, respectively. Lower MNBI independently predicts increased pharyngeal reflux in patients with LPS, with potential adjunctive value for laryngopharyngeal reflux disease diagnosis on objective testing.<\/jats:p>","DOI":"10.1093\/dote\/doag097","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:38:21Z","timestamp":1787053101000},"source":"Crossref","is-referenced-by-count":0,"title":["Mean nocturnal baseline impedance predicts increased pharyngeal reflux on hypopharyngeal-esophageal pH-impedance monitoring in patients with laryngopharyngeal symptoms"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-8122","authenticated-orcid":false,"given":"Jennifer X","family":"Cai","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]},{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]},{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence F","family":"Borges","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]},{"name":"Division of Gastroenterology, Mount Auburn Hospital , Cambridge, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1526-352X","authenticated-orcid":false,"given":"Wai-Kit","family":"Lo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]},{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Carroll","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]},{"name":"Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1709-8230","authenticated-orcid":false,"given":"Walter W","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital , Boston, MA ,","place":["USA"]},{"name":"Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"2026091415445504700_ref1","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/MOG.0000000000001108","article-title":"Update on laryngopharyngeal reflux disease","volume":"41","author":"Algara","year":"2025","journal-title":"Curr Opin Gastroenterol"},{"key":"2026091415445504700_ref2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1067\/mhn.2002.125760","article-title":"Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery","volume":"127","author":"Koufman","year":"2002","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2026091415445504700_ref3","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.cgh.2022.12.038","article-title":"Modern day approach to extraesophageal reflux: clearing the murky lens","volume":"21","author":"Yadlapati","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026091415445504700_ref4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/nyas.14728","article-title":"An update on current treatment strategies for laryngopharyngeal reflux symptoms","volume":"1510","author":"Krause","year":"2022","journal-title":"Ann N Y Acad Sci"},{"key":"2026091415445504700_ref5","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1136\/gutjnl-2023-330616","article-title":"Updates to the modern diagnosis of GERD: Lyon consensus 2.0","volume":"73","author":"Gyawali","year":"2024","journal-title":"Gut"},{"key":"2026091415445504700_ref6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s11605-011-1741-1","article-title":"How much pharyngeal exposure is \"normal\"? 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