Flexible OGD for Symptomatic Laryngopharyngeal Reflux?

Abstract

Objective: 1) To evaluate the flexible oesophagogastroduodenoscopy (FOGD) service offered by an ENT department in a university teaching hospital. 2) To determine whether FOGD has significant benefit in patients with LPR. 3) Is TNE (transnasal esophagoscopy) an alternative in this group of patients?

Method: Study designed as service evaluation of esophagogastroduodenoscopy performed by the otolaryngologist. Retrospective data were collected from the endoscopy and ENT departments over 2½ years. Included were esophagogastroduodenoscopy performed by an otolaryngologist for laryngopharyngeal reflux. Patients were on proton pump inhibitors (PPI), and some had speech therapy.

Results: Data will be analyzed with regard to presenting symptoms, endoscopy findings, management, and follow-up. Outcomes were measured in terms of how many underwent the full procedure as defined by the JAG (Joint Advisory Group) guidelines; accuracy of records; and whether endoscopy findings guided treatment. Was symptom control achieved, and were other treatments required? Outcomes were compared with the literature. The majority of patients benefited in terms of symptom control from initial medical treatment. About 30% required further investigations and/or treatment. The local cost-benefit of flexible esophagogastroduodenoscopy and the possibility of transnasal esophagoscopy as an alternative service are discussed.

Conclusion: This project will provide further insight into the flexible esophagogastroduodenoscopy service provided by the ENT team. It is anticipated that recommendations will be beneficial to stakeholders in improving the service to patients, and areas for future research will be identified.