{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:52:25Z","timestamp":1783389145541,"version":"3.54.6"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"IRIS Grant","award":["2018"],"award-info":[{"award-number":["2018"]}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the features of patients with laryngopharyngeal reflux (LPR) who did not respond to medical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective uncontrolled study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multicenter study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with LPR at 24\u2010hour HEMII\u2010pH monitoring (hypopharyngeal\u2010esophageal multichannel intraluminal impedance\u2013pH) were prospectively recruited from 3 European university centers. Patients were treated with 3\u2010 to 6\u2010month medication (proton pump inhibitor and alginate) and categorized as mild to moderate responders, high responders, or nonresponders according to Reflux Symptom Score (RSS) changes at 6\u00a0months posttreatment. The predictive value of the following outcomes was studied: epidemiologic data, HEMII\u2010pH, gastrointestinal endoscopy findings, baseline RSS and Reflux Sign Assessment, and early therapeutic response (6\u2010week RSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 148 patients completed the evaluations, accounting for 40\u00a0mild to moderate responders (20%\u201060% RSS changes), 76 high responders (&gt;60% RSS changes), and 32\u00a0nonresponders. Nonresponders presented more often with hiatal hernia and lower esophageal sphincter insufficiency when compared with mild to moderate and high responders (<jats:italic>P<\/jats:italic> =. 032). Baseline otolaryngologic, digestive, and respiratory RSS and the number of pharyngeal reflux events at the HEMII\u2010pH were predictive of the 6\u2010month therapeutic response (<jats:italic>P<\/jats:italic> &lt;. 05). The early therapeutic response (6 weeks posttreatment) was predictive of the 6\u2010month treatment response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hiatal hernia and baseline and 6\u2010week RSS were the most predictive indicators of therapeutic effectiveness in patients with LPR.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221075009","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T12:05:01Z","timestamp":1643717101000},"page":"852-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Laryngopharyngeal Reflux: Evolution and Predictive Value of Symptoms and pH\u2010Impedance Features on Clinical Evolution"],"prefix":"10.1002","volume":"167","author":[{"given":"Jerome R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Foch Hospital School of Medicine University Paris 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