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Erschienen in: European Archives of Oto-Rhino-Laryngology 4/2020

01.04.2020 | Head and Neck

Influence of proton pump inhibitor therapy on occurrence of voice prosthesis complications

verfasst von: Ana Danic Hadzibegovic, Ana Kozmar, Irzal Hadzibegovic, Drago Prgomet, Davorin Danic

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2020

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Abstract

Purpose

It has been shown that the reflux of the gastric content to the proximal oesophagus influences incidence of voice prosthesis (VP) complications in laryngectomized patients. We conducted prospective randomised study to investigate the relationship between pepsin concentration in saliva and occurrence of VP complications before and after 3 months of proton pump inhibitor (PPI) therapy.

Methods

60 laryngectomized patients with VP and 30 controls were included in the study. Saliva samples were collected in the morning and concentration of pepsin were measured by Human Pepsin (PG) ELISA kit. Thirty-Four (57%) patients reported one or more VP complication and were randomised in two groups, with and without PPI therapy, 40 mg pantoprazole per day for 3 months.

Results

Patients who had longer time since last VP change had higher incidence of periprosthetic and transprosthetic leakage and Candida colonisation. Pepsin was found in all saliva samples. Median saliva pepsin concentration level did not significantly differ between laryngectomized patients and control subjects, or between patients with and without VP complications, and there was no correlation between saliva pepsin concentration levels and type of VP complication. After 3 months therapy, there was no difference in median saliva pepsin level or incidence of VP complication between patients with and without PPI therapy.

Conclusion

Although reflux was proposed to be associated with VP complications and pepsin was proven as a most sensitive and specific marker of EER, we did not find any statistically significant correlation between pepsin levels and occurrence of VP complications. A 3 months 40 mg pantoprazole therapy was ineffective in reduction of VP complications in our study group.
Literatur
1.
Zurück zum Zitat Barbiera F, Fiorentino E, Lo Greco V, Galia M, Musto GA, Runza G, Sorrentino F, Sparacia G, Lo CA (2003) Digital cineradiography of the pharynx and the oesophagus after total or partial laryngectomy. Radiol Med 106:169–177PubMed Barbiera F, Fiorentino E, Lo Greco V, Galia M, Musto GA, Runza G, Sorrentino F, Sparacia G, Lo CA (2003) Digital cineradiography of the pharynx and the oesophagus after total or partial laryngectomy. Radiol Med 106:169–177PubMed
2.
Zurück zum Zitat Choi EC, Hong WP, Kim CB, Yoon HC, Nam JI, Son EJ, Kim KM, Kim SH (2003) Changes of esophageal motility after total laryngectomy. Otolaryngol Head Neck Surg 128:691–699CrossRef Choi EC, Hong WP, Kim CB, Yoon HC, Nam JI, Son EJ, Kim KM, Kim SH (2003) Changes of esophageal motility after total laryngectomy. Otolaryngol Head Neck Surg 128:691–699CrossRef
3.
Zurück zum Zitat Kuhnt T, Jirsak N, Müller AC, Pelz T, Gernhardt C, Schaller HG, Janich M, Gerlach R, Dunst J (2005) Quantitative and qualitative investigations of salivary gland function in dependence on irradiation dose and volume for reduction of xerostomia in patients with head-and-neck cancer. Strahlenther Onkol 181:520–528CrossRef Kuhnt T, Jirsak N, Müller AC, Pelz T, Gernhardt C, Schaller HG, Janich M, Gerlach R, Dunst J (2005) Quantitative and qualitative investigations of salivary gland function in dependence on irradiation dose and volume for reduction of xerostomia in patients with head-and-neck cancer. Strahlenther Onkol 181:520–528CrossRef
4.
Zurück zum Zitat Izdebski K, Fontanesi J, Ross JC, Hetzler D (1988) The effects of irradiation on alaryngeal voice of totally laryngectomized patients. Int J Radiat Oncol Biol Phys 14:1281–1286CrossRef Izdebski K, Fontanesi J, Ross JC, Hetzler D (1988) The effects of irradiation on alaryngeal voice of totally laryngectomized patients. Int J Radiat Oncol Biol Phys 14:1281–1286CrossRef
5.
Zurück zum Zitat Lorenz KJ, Grieser L, Ehrhart T, Maier H (2010) Role of reflux in tracheoesophageal fistula problems after laryngectomy. Ann Otol Rhinol Laryngol 119:719–728CrossRef Lorenz KJ, Grieser L, Ehrhart T, Maier H (2010) Role of reflux in tracheoesophageal fistula problems after laryngectomy. Ann Otol Rhinol Laryngol 119:719–728CrossRef
6.
Zurück zum Zitat Lorenz KJ, Kraft K, Graf F, Pröpper C, Steinestel K (2015) Importance of cellular tight junction complexes in the development of periprosthetic leakage after prosthetic voice rehabilitation. HNO 63(3):171–172CrossRef Lorenz KJ, Kraft K, Graf F, Pröpper C, Steinestel K (2015) Importance of cellular tight junction complexes in the development of periprosthetic leakage after prosthetic voice rehabilitation. HNO 63(3):171–172CrossRef
7.
Zurück zum Zitat Lorenz KJ, Kraft K, Graf F, Pröpper C, Steinestel K (2015) Role of reflux-induced epithelial-mesenchymal transition in periprosthetic leakage after prosthetic voice rehabilitation. Head Neck 37(4):530–536CrossRef Lorenz KJ, Kraft K, Graf F, Pröpper C, Steinestel K (2015) Role of reflux-induced epithelial-mesenchymal transition in periprosthetic leakage after prosthetic voice rehabilitation. Head Neck 37(4):530–536CrossRef
8.
Zurück zum Zitat Pattani KM, Morgan M, Nathan CO (2009) Reflux as a cause of tracheoesophageal puncture failure. Laryngoscope 119:121–125CrossRef Pattani KM, Morgan M, Nathan CO (2009) Reflux as a cause of tracheoesophageal puncture failure. Laryngoscope 119:121–125CrossRef
9.
Zurück zum Zitat Cocuzza S, Bonfiglio M, Chiaramonte R, Aprile G, Mistretta A, Grosso G, Serra A (2012) Gastroesophageal reflux disease and postlaryngectomy tracheoesophageal fistula. Eur Arch Otorhinolaryngol 269:1483–1488CrossRef Cocuzza S, Bonfiglio M, Chiaramonte R, Aprile G, Mistretta A, Grosso G, Serra A (2012) Gastroesophageal reflux disease and postlaryngectomy tracheoesophageal fistula. Eur Arch Otorhinolaryngol 269:1483–1488CrossRef
10.
Zurück zum Zitat Samuels TL, Johnston N (2010) Pepsin as a marker of extraesophageal reflux. Ann Otol Rhinol Laryngol 119:203–208CrossRef Samuels TL, Johnston N (2010) Pepsin as a marker of extraesophageal reflux. Ann Otol Rhinol Laryngol 119:203–208CrossRef
11.
Zurück zum Zitat Calvo-Henríquez C, Ruano-Ravina A, Vaamonde P, Martínez-Capoccioni G, Martín-Martín C (2017) Is pepsin a reliable marker of laryngopharyngeal reflux? A systematic review. Otolaryngol Head Neck Surg 157(3):385–391CrossRef Calvo-Henríquez C, Ruano-Ravina A, Vaamonde P, Martínez-Capoccioni G, Martín-Martín C (2017) Is pepsin a reliable marker of laryngopharyngeal reflux? A systematic review. Otolaryngol Head Neck Surg 157(3):385–391CrossRef
12.
Zurück zum Zitat Wang J, Zhao Y, Ren J, Xu Y (2018) Pepsin in saliva as a diagnostic biomarker in laryngopharyngeal reflux: a meta-analysis. Eur Arch Otorhinolaryngol. 275(3):671–678CrossRef Wang J, Zhao Y, Ren J, Xu Y (2018) Pepsin in saliva as a diagnostic biomarker in laryngopharyngeal reflux: a meta-analysis. Eur Arch Otorhinolaryngol. 275(3):671–678CrossRef
13.
Zurück zum Zitat Bock JM, Brawley MK, Johnston N, Samuels T, Massey BL, Campbell BH, Toohill RJ, Blumin JH (2010) Analysis of pepsin in tracheoesophageal puncture sites. Ann Otol Rhinol Laryngol 119:799–805CrossRef Bock JM, Brawley MK, Johnston N, Samuels T, Massey BL, Campbell BH, Toohill RJ, Blumin JH (2010) Analysis of pepsin in tracheoesophageal puncture sites. Ann Otol Rhinol Laryngol 119:799–805CrossRef
14.
Zurück zum Zitat de Coul BO, Hilgers F, Balm A, Tan I, van den Hoogen F, van Tinteren H (2000) A decade of postlaryngectomy vocal rehabilitation in 318 patients: a single Institutions experience with consistent application of provox indwelling voice prostheses. Arch Otolaryngol Head Neck Surg 126:1320–1328CrossRef de Coul BO, Hilgers F, Balm A, Tan I, van den Hoogen F, van Tinteren H (2000) A decade of postlaryngectomy vocal rehabilitation in 318 patients: a single Institutions experience with consistent application of provox indwelling voice prostheses. Arch Otolaryngol Head Neck Surg 126:1320–1328CrossRef
15.
Zurück zum Zitat Lukinović J, Bilić M, Raguž I, Živković T, Kovač-Bilić L, Prgomet D (2012) Overview of 100 patients with voice prosthesis after total laryngectomy—experience of single institution. Coll Antropol 36:99–102CrossRef Lukinović J, Bilić M, Raguž I, Živković T, Kovač-Bilić L, Prgomet D (2012) Overview of 100 patients with voice prosthesis after total laryngectomy—experience of single institution. Coll Antropol 36:99–102CrossRef
16.
Zurück zum Zitat Malik T, Bruce I, Cherry J (2007) Surgical complications of tracheo-oesophageal puncture and speech valves. Curr Opin Otolaryngol Head Neck Surg 15:117–122CrossRef Malik T, Bruce I, Cherry J (2007) Surgical complications of tracheo-oesophageal puncture and speech valves. Curr Opin Otolaryngol Head Neck Surg 15:117–122CrossRef
17.
Zurück zum Zitat Acton LM, Ross DA, Sasaki CT, Leder SB (2008) Investigation of tracheoesophageal voice prosthesis leakage patterns: patient’s self report versus clinician’s confirmation. Head Neck 30:618–621CrossRef Acton LM, Ross DA, Sasaki CT, Leder SB (2008) Investigation of tracheoesophageal voice prosthesis leakage patterns: patient’s self report versus clinician’s confirmation. Head Neck 30:618–621CrossRef
18.
Zurück zum Zitat Hilgers FJ, Balm AJ (1993) Long-term results of vocal rehabilitation after total laryngectomy with the low-resistance, indwelling Provox voice prosthesis system. Clin Otolaryngol Allied Sci 18:517–523CrossRef Hilgers FJ, Balm AJ (1993) Long-term results of vocal rehabilitation after total laryngectomy with the low-resistance, indwelling Provox voice prosthesis system. Clin Otolaryngol Allied Sci 18:517–523CrossRef
19.
Zurück zum Zitat Hutcheson KA, Lewin JS, Sturgis EM, Risser J (2012) Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy. Head Neck 34:557–567CrossRef Hutcheson KA, Lewin JS, Sturgis EM, Risser J (2012) Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy. Head Neck 34:557–567CrossRef
20.
Zurück zum Zitat Boscolo-Rizzo P, Marchiori C, Gava A, Da Mosto MC (2008) The impact of radiotherapy and GERD on in situ lifetime of indwelling voice prostheses. Eur Arch Otorhinolaryngol 265:791–796CrossRef Boscolo-Rizzo P, Marchiori C, Gava A, Da Mosto MC (2008) The impact of radiotherapy and GERD on in situ lifetime of indwelling voice prostheses. Eur Arch Otorhinolaryngol 265:791–796CrossRef
21.
Zurück zum Zitat Hutcheson KA, Lewin JS, Sturgis EM, Kapadia A, Risser J (2011) Enlarged tracheoesophageal puncture after total laryngectomy: a systematic review and meta-analysis. Head Neck 33:20–30CrossRef Hutcheson KA, Lewin JS, Sturgis EM, Kapadia A, Risser J (2011) Enlarged tracheoesophageal puncture after total laryngectomy: a systematic review and meta-analysis. Head Neck 33:20–30CrossRef
22.
Zurück zum Zitat de Carpentier JP, Ryder WD, Saeed SR, Woolford TJ (1996) Survival times of Provox valves. J Laryngol Otol 110:37–42CrossRef de Carpentier JP, Ryder WD, Saeed SR, Woolford TJ (1996) Survival times of Provox valves. J Laryngol Otol 110:37–42CrossRef
23.
Zurück zum Zitat Delsupehe K, Zink I, Lejaegere M, Delaere P (1998) Prospective randomized comparative study of tracheoesophageal voice prosthesis: Blom-Singer versus Provox. Laryngoscope 108:1561–1565CrossRef Delsupehe K, Zink I, Lejaegere M, Delaere P (1998) Prospective randomized comparative study of tracheoesophageal voice prosthesis: Blom-Singer versus Provox. Laryngoscope 108:1561–1565CrossRef
24.
Zurück zum Zitat Sifrim D, Castell D, Dent J, Kahrilas PJ (2004) Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux. Gut 53:1024–1031CrossRef Sifrim D, Castell D, Dent J, Kahrilas PJ (2004) Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux. Gut 53:1024–1031CrossRef
25.
Zurück zum Zitat Andersson O, Ylitalo R, Finizia C, Bove M, Magnus R (2006) Pharyngeal reflux episodes at pH 5 in healthy volunteers. Scand J Gastroenterol 41:138–143CrossRef Andersson O, Ylitalo R, Finizia C, Bove M, Magnus R (2006) Pharyngeal reflux episodes at pH 5 in healthy volunteers. Scand J Gastroenterol 41:138–143CrossRef
26.
Zurück zum Zitat Vaezi MF, Schroeder PL, Richter JE (1997) Reproducibility of proximal probe pH parameters in 24-h ambulatory esophageal pH monitoring. Am J Gastroenterol 92:825–829PubMed Vaezi MF, Schroeder PL, Richter JE (1997) Reproducibility of proximal probe pH parameters in 24-h ambulatory esophageal pH monitoring. Am J Gastroenterol 92:825–829PubMed
27.
Zurück zum Zitat Hirano I, Richter JE (2007) ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol 102:668–685CrossRef Hirano I, Richter JE (2007) ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol 102:668–685CrossRef
28.
Zurück zum Zitat Oelschlager BK, Quiroga E, Isch JA, Cuenca-Abente F (2006) Gastroesophageal and pharyngeal reflux detection using impedance and 24-hour pH monitoring in asymptomatic subjects: defining the normal environment. J Gastrointest Surg 10:54–62CrossRef Oelschlager BK, Quiroga E, Isch JA, Cuenca-Abente F (2006) Gastroesophageal and pharyngeal reflux detection using impedance and 24-hour pH monitoring in asymptomatic subjects: defining the normal environment. J Gastrointest Surg 10:54–62CrossRef
29.
Zurück zum Zitat Na SY, Kwon OE, Lee YC, Eun YG (2016) Optimal timing of saliva collection to detect pepsin in patients with laryngopharyngeal reflux. Laryngoscope 126(12):2770–2773CrossRef Na SY, Kwon OE, Lee YC, Eun YG (2016) Optimal timing of saliva collection to detect pepsin in patients with laryngopharyngeal reflux. Laryngoscope 126(12):2770–2773CrossRef
30.
Zurück zum Zitat Lechien JR, Akst LM, Hamdan AL, Schindler A, Karkos PD, Barillari MR, Calvo-Henriquez C, Crevier-Buchman L, Finck C, Eun YG, Saussez S, Vaezi MF (2019) Evaluation and management of laryngopharyngeal reflux disease: state of the art review. Otolaryngol Head Neck Surg 160(5):762–782CrossRef Lechien JR, Akst LM, Hamdan AL, Schindler A, Karkos PD, Barillari MR, Calvo-Henriquez C, Crevier-Buchman L, Finck C, Eun YG, Saussez S, Vaezi MF (2019) Evaluation and management of laryngopharyngeal reflux disease: state of the art review. Otolaryngol Head Neck Surg 160(5):762–782CrossRef
Metadaten
Titel
Influence of proton pump inhibitor therapy on occurrence of voice prosthesis complications
verfasst von
Ana Danic Hadzibegovic
Ana Kozmar
Irzal Hadzibegovic
Drago Prgomet
Davorin Danic
Publikationsdatum
01.04.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 4/2020
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-05784-4

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