Clinical Findings, Feasibility, and Patient Tolerance of Nasopharyngeal Dx-pH System for Detecting Nasopharyngeal Reflux Disease.

OBJECTIVE

To investigate the feasibility, patient tolerance, and clinical findings of the Dx-pH system for detecting nasopharyngeal reflux disease (NRD).

METHODS

Patients with idiopathic and chronic nasal complaints were recruited from the European Reflux Clinic between July 2022 and July 2024. Patients underwent 24-hour nasal Dx-pH system for detecting NRD. Reflux symptom score, sinonasal outcome tool-22, and reflux sign assessment were used to document symptoms and findings. A tolerance 19-item questionnaire was used to evaluate the symptom prevalence and severity of the probe placement and position throughout the 24-hour testing, ranging from 0 (no annoyance) to 95 (severe annoyance).

RESULTS

Twenty-three patients completed the evaluations (11 females). The mean age was 51.5 ± 17.0 years. Eighteen (78.3%) patients had NRD with a mean number of nasopharyngeal reflux events of 67.1 ± 65.9. Mulberry inferior turbinate was reported in 15 patients (65.2%), nasal dryness in nine patients (39.1%), and crusting in six patients (26.1%). The mean tolerance score was 15.2 ± 11.9. The most prevalent symptoms during the 24-hour pH-testing included nasal discomfort during probe placement (73.9%), throat discomfort during probe placement (69.6%), overall discomfort throughout the testing period (69.6%), cough during the testing day (65.2%), and postnasal drip sensation during the monitoring period (60.9%). Patients reported the highest discomfort scores for overall discomfort during the testing night and throat discomfort during probe placement. Significant positive correlations were observed between patient-reported tolerance difficulties and otolaryngological reflux symptom severity (rs = 0.644, P = 0.002) and mulberry inferior turbinate (rs = 0.432; P = 0.045).

CONCLUSION

The Dx-pH system effectively detects NRD with acceptable patient tolerance, though discomfort correlates with symptom severity. This diagnostic approach suggests a high NRD prevalence among chronic nasal complaint patients.