New Technology for the Diagnosis and Treatment of Clinical Manifestations of Laryngopharyngeal Reflux

Aim: to present the algorithm for differential diagnosis in patients with laryngopharyngeal symptoms, as well as diagnostic opportunities of the 24-hour hypopharyngeal-esophageal multichannel intraluminal pH-impedance monitoring using a special multichannel probe catheter for diagnosis of laryngopharyngeal reflux.

Key points. Laryngopharyngeal symptoms are symptoms that can be caused by retrograde reflux of gastric contents to the proximal segment esophagus, pharynx and larynx, the so-called laryngopharyngeal reflux. These symptoms include cough, sore throat, clearing the throat, excessive mucus production, hoarseness/voice change. Patients should report these complaints at least twice a week for more than 8 weeks. Isolated laryngopharyngeal reflux may be the main factor in the pathogenesis of laryngopharyngeal reflux disease — a disease of the pharynx and upper respiratory tract caused by the pathological flow of contents from the stomach into the larynx, which is manifested by laryngopharyngeal symptoms. In addition, laryngopharyngeal symptoms may be based on hypersensitivity of the laryngopharyngeal mucosa. When laryngopharyngeal symptoms are combined with heartburn and regurgitation, the physician should rule out extraesophageal manifestations of gastroesophageal reflux disease. Due to the nonspecific nature of laryngopharyngeal symptoms, the patient’s examination includes collecting complaints and medical history, filling out questionnaires, consulting specialists in related specialties, conducting laryngoscopy, esophagogastroduodenoscopy, 24-hour hypopharyngeal-esophageal multichannel intraluminal pH-impedance monitoring using a multichannel probe catheter, which is the main method in diagnostics of laryngopharyngeal reflux with an assessment of the symptom index, as well as the chemical and physical properties of the refluxate. The staff of the Department and Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology at Sechenov University has developed a new technology that includes a practical diagnostic algorithm and, for the first time in Russia, constructed the special probe catheter for hypopharyngeal-esophageal multichannel intraluminal 24-hour pH-impedance monitoring, which is registered as an invention in the Federal Service for Intellectual Property (Rospatent) as “The method for performing pH-impedance monitoring in the diagnosis of laryngopharyngeal reflux” (state registration number No. 2845916 dated August 27, 2025).

Conclusion. Differentiating between laryngopharyngeal reflux disease and extraesophageal manifestations of gastroesophageal reflux disease in patients with laryngopharyngeal symptoms based solely on clinical manifestations is challenging. To confirm the diagnosis, 24-hour pH-impedance monitoring with a specially designed laryngopharyngeal probe is necessary. This will determine further patient management, thereby improving the quality of medical care for patients with laryngopharyngeal reflux.

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