{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:58:00Z","timestamp":1793404680344,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Patients with laryngopharyngeal reflux (LPR) symptoms may not respond to proton pump inhibitors (PPI) if they have an alternative laryngeal diagnosis or high-volume reflux. Transoral incisionless fundoplication (TIF) or TIF with concomitant hiatal hernia repair (cTIF) are effective in decreasing symptoms of gastroesophageal reflux disease (GERD) but are not well studied in patients with LPR symptoms. This prospective multicenter study assessed the patient-reported and clinical outcomes after TIF\/cTIF in patients with LPR symptoms and proven GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with refractory LPR symptoms (reflux symptom index [RSI]\u2009&gt;\u200913) and with erosive esophagitis, Barrett\u2019s esophagus, and\/or pathologic acid reflux by distal esophageal pH testing were evaluated before and after a minimum of 6\u2009months after TIF\/cTIF. The primary outcome was normalization of RSI. Secondary outcomes were &gt;50% improvement in GERD-Health-Related Quality of Life (GERD-HRQL), normalization of esophageal acid exposure time, discontinuation of PPI, and patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-nine patients had TIF (n\u2009=\u200926) or cTIF (n\u2009=\u200923) with at least 6\u2009months follow-up. Mean pre- and post TIF\/cTIF RSI were 23.6 and 5.9 (mean difference: 17.7, P\u2009&lt;\u2009.001). Post TIF\/cTIF, 90% of patients had improved GERD-HQRL score, 85% normalized RSI, 75% normalized esophageal acid exposure time, and 80% discontinued PPI. No serious procedure-related adverse events occurred. Patient satisfaction was 4% prior to TIF\/cTIF and 73% after TIF\/cTIF ( P\u2009&lt;\u2009.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In patients with objective evidence of GERD, TIF, or cTIF are safe and effective in controlling LPR symptoms as measured by normalization of RSI and improvement in patient satisfaction after TIF\/cTIF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level 4<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894211037414","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T05:40:15Z","timestamp":1628660415000},"page":"662-670","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux"],"prefix":"10.1177","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6246-0035","authenticated-orcid":false,"given":"Grace E.","family":"Snow","sequence":"first","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Dbouk","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal and Liver Pathology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8925-0545","authenticated-orcid":false,"given":"Lee M.","family":"Akst","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Ihde","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Matagorda Regional Medical Group, Bay City, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasa","family":"Zarnegar","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Janu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fox Valley Surgical Associates, Appleton, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northern Nevada Medical Center, Sparks, NV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Eskarous","sequence":"additional","affiliation":[{"name":"Department of Medicine, Easton Hospital, Easton, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Sohagia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Easton Hospital, Easton, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumon I.","family":"Dhar","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"Irene Canto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 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