Laryngopharyngeal reflux among patients undergoing bariatric surgery

Ramasamy, Purushotman and Kumarasamy, Vigneswaran and Singh, Avatar Singh Mohan and Abu Bakar, Mohd Zulkiflee B. and Narayanan, Prepageran and Ganapathy, Shubash Shander and Ramasamy, Umasangar and Vinayak, C. Rajkumar (2021) Laryngopharyngeal reflux among patients undergoing bariatric surgery. Obesity Surgery, 31 (8). pp. 3749-3757. ISSN 0960-8923, DOI

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Purpose The effect of altered subsphincteric gastric volume and pressure after bariatric surgery on laryngopharyngeal reflux (LPR) remains largely unknown. This was a cross-sectional pilot study conducted between January 2018 and January 2019 to identify changes in LPR symptoms and signs in bariatric surgery patients presurgery and postsurgery. Materials and Methods Thirty-four patients listed for bariatric surgery in a single tertiary referral center were recruited, where 31 (77.4% female, mean age 46.3 +/- 8.9 years) fulfilled the eligibility criteria. Of the eligible patients, 54.8% and 45.2% underwent sleeve gastrectomy (SG) and gastric bypass (GB), respectively. LPR symptoms were assessed using the self-reported reflux symptom index (RSI). Video-recorded endolaryngeal signs were scored using the reflux finding score (RFS) by two blinded otolaryngologists. Patients' presurgical and 3-month postsurgical body mass index (BMI), RSI, and RFS were determined. Patients were deemed as having LPR when RSI > 13 or RFS > 7. Results There was a significant correlation between the postsurgical RSI and RFS changes (Pearson's r = 0.474, p = 0.007). Of the 31 patients, 12.9% (RSI) and 6.4% (RFS) recovered from preexisting LPR, whereas 22.6% (RSI) and 3.2% (RFS) developed new de novo LPR postsurgery. The postsurgical mean RFS change improved significantly in the GB group compared with that of the SG group (p < 0.05). Conclusion LPR is best assessed clinically using a multimodal approach (RSI and RFS). Bariatric surgery may worsen or lead to de novo LPR. Recognizing the LPR outcomes in these patients is paramount for optimal voice, speech, and swallowing functions.

Item Type: Article
Funders: None
Uncontrolled Keywords: Laryngopharyngeal reflux; Bariatric surgery; Sleeve gastrectomy; Gastric bypass; Reflux symptom index; Reflux finding score
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 23 Jun 2022 07:19
Last Modified: 23 Jun 2022 07:19

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