Determination of mucociliary clearance in patients with laryngopharyngeal reflux symptoms – preliminary results

Summary: Introduction: Mucociliary clearance represents an important protective mechanism of the respiratory tract. Results of multiple studies indicate that gastroesophageal reflux can participate in worsening mucociliary clearance leading to laryngopharyngeal reflux symptoms including recurrent upper respiratory tract infections. Thereby, we decided to provide ciliary beat frequency of the upper respiratory tract epithelium in patients with laryngopharyngeal reflux. Materials and methods: We enrolled 23 patients with laryngopharyngeal reflux symptoms. Control group consisted of 9 healthy volunteers. Patients were enrolled upon a positive questionnaire reflux symptom index (RSI >13 points), with no proton pump inhibitor treatment. We obtained a nasopharyngeal swab and evaluated ciliary beat frequency of the respiratory epithelium using highspeed videomicroscopy and special sofware Ciliary Analysis. We compared the values of ciliary beat frequency with values from healthy volunteers. Results: We provided median, minimal and maximum values of ciliary beat frequency. Median ciliary beat frequency in healthy volunteers was significantly higher than in patients with laryngopharyngeal reflux symptomatology (10.86 ± 1.67 vs. 6.6 ± 2.2; P <0.001). Maximum ciliary beat frequency was also significantly higher in healthy volunteers than in patients with LPR (17.9 ± 0.95 vs. 15.3 ± 2.39; P <0.001). Minimal value had no significant difference. Correlation analysis showed an inverse correlation between median ciliary beat frequency of the respiratory epithelium and LPR symptoms (RSI value) (P <0.04). Conclusion: Patients with laryngopharyngeal reflux symptoms had lower ciliary beat frequency compared to healthy volunteers. The degree of frequency defect correlates with the degree of their laryngopharyngeal symptoms. More studies are needed to confirm direct evidence of gastroesophageal reflux etiology in mucociliary clearance worsening. Key words: mucociliary clearance – laryngopharyngeal reflux – cilia