Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.
Humans ; Hypopharynx/surgery* ; Pharynx/surgery* ; Endoscopes ; Surgical Instruments ; Foreign Bodies/diagnosis*

Synovial sarcoma of the hypopharynx is an uncommon malignancy, with less than 100 cases reported in available journals. We report a case of a 22-year-old female presenting with dysphagia and enlarging hypopharyngeal mass, clinically diagnosed as hypopharyngeal malignancy, right, at least stage III. Histopathologic examination including immunohistochemistry study with TLE1 and SS18 Fluorescence In Situ Hybridization (FISH) confirm the diagnosis of synovial sarcoma. This is the first reported case of synovial sarcoma of the hypopharynx in the Philippines confirmed by SS18 FISH. Due to the size of the mass, chemoradiotherapy followed by surgery is the current plan of management for this patient.
Sarcoma ; Hypopharynx

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
Humans ; Hypopharynx/diagnostic imaging* ; Valsalva Maneuver ; Hypopharyngeal Neoplasms/surgery* ; Tomography, X-Ray Computed ; Carcinoma

Cryotherapy ; Humans ; Hypopharynx ; Respiratory System

Humans ; Laryngopharyngeal Reflux ; Hypopharynx ; Respiratory System

Objective: To investigate the effect of gastroesophageal reflux disease (GERD) on the clinical characteristics of patients with laryngopharyngeal reflux disease(LPRD). Methods: The data of 141 patients with symptoms of LPRD, who were admitted to the Department of Pharyngology, Laryngology& Phonosurgery at the Sixth Medical Center of the PLA General Hospital from November 2020 to October 2021, were retrospectively analyzed.There were 118 males and 23 females, aged 28-75 (56.72±10.04) years old. The included patients underwent simultaneous 24-hour hypopharyngeal and esophageal multichannel intraluminal impedance pH monitoring (24h-HEMII-pH), salivary pepsin test at multiple times, Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). One laryngopharyngeal reflux event on 24 h-HEMII-pH monitoring results was used as a diagnostic criterion for LPRD. And the duration of lower esophageal pH<4.0>4.0% at 24 h or DeMeester score>14.7 were used as diagnostic criteria for GERD. Among them, patients with both positive LPRD and GERD were classified as L&G group, patients with positive LPRD and negative GERD were classified as IL group, patients with negative LPRD and positive GERD were classified as IG group, and patients with both negative LPRD and GERD were classified as N group. The differences in the clinical characteristics of reflux and salivary pepsin assay in each group were statistically analyzed. SPSS 23.0 software was applied for statistical analysis. Results: According to the 24 h-HEMII-pH results, 116 (82.3%) patients were diagnosed with LPRD and 45 (31.9%) with GERD, including 82 (58.2%) in the IL group, 34 (24.1%) in the L&G group, 11 (7.8%) in the IG group, and 14 (9.9%) in the N group. Based on the salivary pepsin test, a total of 106 patients had positive results, and the L&G group had a significantly higher rate of positive total salivary pepsin test (94.1%) and positive morning test (70.6%) than the IL group (75.6%, 26.8%), IG group (63.6%, 27.3%) and N group (35.7%, 28.6%), with chi-square values of 19.01 and 20.81, both with P<0.001. The patients in the L&G group had a significantly higher RSI score (14.0) than the IL group (7.0), IG group (1.0) and N group (0), H=52.26,P<0.001. The difference in RFS between the L&G and IL groups was not statistically significant (Z=-0.92,P>0.05). Conclusion: Combined with GERD, LPRD patients have more obvious clinical symptoms and higher positive rate of pepsin test in saliva.
Aged ; Female ; Humans ; Male ; Middle Aged ; Esophageal pH Monitoring ; Hypopharynx ; Laryngopharyngeal Reflux ; Pepsin A ; Retrospective Studies ; Adult

Objective: To investigate the daily variation of LPR and the significance of 48-hour oropharyngeal pH monitoring in the diagnosis of LPRD. Methods: 72 subjects with suspected LPRD who were treated in our department from June 2018 to June 2021 were included. All patients were hospitalized to complete continuous 48-hour oropharyngeal Dx-pH monitoring. The consistency of Ryan index and W index and the correlation of various reflux parameters between the first and second 24-hour were compared. SPSS 24.0 was used for statistical analysis. Results: All 72 subjects successfully completed 48-hour oropharyngeal Dx-pH monitoring. Ryan index was positive in 11 cases (15.2%) in the first 24-hour, in 17 cases (23.6%) in the second 24-hour, in 5 cases (6.9%) both first and second, and in 23 cases (31.9%) in either 24-hour, Kappa=0.211 (P=0.064), 18 cases (25%) had inconsistent results of the first 24-hour and the second 24-hour, and there was no significant difference in the positive rate between the first and second (P=0.234). The number of positive cases in 48-hour monitoring increased by 109.1% compared with 24-hour monitoring.For W index, 49 cases (68.1%) were positive in the first 24-hourf 53 cases (73.6%) were positive in the second 24-hour, 42 cases (58.3%) were positive both first and second, and 58 cases (80.6%) were positive in either 24-hour, Kappa=0.477 (P<0.001), 16 cases (22.2%) had inconsistent results of the first and second, and there was no significant difference in the positive rate between the first and second (P=0.804). The number of positive cases in 48-hour monitoring increased by 18.4% compared with 24-hour monitoring. There was no significant difference in all the reflux parameters of first and second (P>0.05). The correlation comparison showed that the correlation of various reflux parameters in the upright position was lower than that in the supine position. Conclusion: Laryngeal reflux has daily variability. Extending the monitoring time of Dx-pH to 48-hour can help reduce the missed diagnosis caused by daily variability; the use of W index can reduce the influence of daily variability on the diagnostic results of LPRD.
Humans ; Laryngopharyngeal Reflux/diagnosis* ; Hydrogen-Ion Concentration ; Hypopharynx ; Larynx

Objective: To explore the basic psychological and personality characteristics of patients with laryngopharyngeal reflux disease (LPRD). Methods: The Minnesota Multiphasic Personality Inventory (MMPI) was used to investigate the psychological personality characteristics of 187 patients with LPRD (Study Group) and 75 healthy subjects (control group) who were treated in the otolaryngology clinic of Wuhan Central Hospital from January 2018 to December 2019. There were 102 males in the study group, aged from 20 to 71 (45.42±10.67) years and 85 females, aged from 18 to 65 (40.97±11.53) years; There were 41 males in the control group, aged from 18 to 67 (41.08±12.03) years and 34 females, aged from 20 to 65 (42.55±12.78) years. SPSS 24.0 software was used for statistical analysis. Results: The T scores of HS hypochondriac scale, D depression scale, Hy hysteria scale, Ma hypomania scale and MAS explicit anxiety scale in LPRD patients were significantly higher than those in healthy controls (t=6.304, 4.293, 5.750, 2.694, 5.178, all P<0.05). Correlation analysis showed that RSI score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale, Ma hypomania scale and MAS explicit Anxiety Scale (r=0.621, 0.402, 0.393, 0.581, all P<0.05); RFS score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale and MAS explicit Anxiety Scale (r=0.315, 0.321, 0.375, P<0.05). Conclusions: Compared with healthy people, LPRD patients have special personality psychological characteristics, which are mainly manifested as excessive attention to themselves, exaggerated illness, depression, sensitivity, somatization of psychological problems, irritability and mania. The severity of both subjective symptoms (RSI) and objective signs (RFS) of LPRD patients are related to their psychological personality characteristics.
Male ; Female ; Humans ; Laryngopharyngeal Reflux/diagnosis* ; Mania ; Hypopharynx ; MMPI ; Personality

Objective: To compare the clinical characteristics of patients with different type of laryngopharyngeal reflux disease in order to study the effect of non-acid reflux on laryngopharyngeal reflux disease. Methods: From January 2015 to January 2020, 349 inpatients or outpatients suspected of having laryngopharyngeal reflux underwent 24-hour multichannel intraluminal impedance pH monitoring (MII-pH). There were 303 male and 46 female patients, with an average age of 56.03 years old ranged from 25 to 81 years old. The reflux symptom index (RSI)and reflux findings score(RFS)were recorded before MII-pH monitoring. The number of acid reflux events and non-acid reflux events in hypopharynx were counted. It was defined mainly acid reflux type when the ratio of acid reflux to all reflux events was greater than 50%, mainly non-acid reflux type when the ratio of non-acid reflux to all reflux events was greater than 50%. The clinical characteristics of patients with different type of reflux were compared. SPSS 19.0 software was used for statistical analysis, and multiple independent samples were compared between groups. The quantitative data were analyzed by multivariate analysis of variance, and the counting data were analyzed by chi-square test, the difference was statistically significant when P<0.05. Results: The 24-hour MII-pH showed that there were 90 patients with no reflux events, 51 patients with mainly acid reflux type, 198 patients with mainly non-acid reflux type and 10 patients with equal acid reflux events and non-acid reflux events. Statistics showed that the RSI(10.72±4.40), RFS(7.70±2.73) and the average number of reflux events(0) in the group without reflux events were significantly lower than those in patients with mainly acid reflux type (RSI 13.16±6.62,RFS 10.08±3.03,average number of reflux events 5.33±3.15,P<0.05) and mainly non-acid reflux type(RSI 13.25±5.54,RFS 8.81±2.54,average number of reflux events 7.93±5.26, P<0.05). There was no significant difference in RSI between the mainly non-acid reflux type group and the mainly acid reflux type group, but the RFS of the mainly non-acid reflux type group was significantly lower than that of the mainly acid reflux type group. The average number of reflux events in the mainly non-acid reflux group was significantly higher than that in the mainly acid reflux type group (P<0.05). Conclusion: The results show that non-acid reflux plays a certain role in laryngopharyngeal reflux disease, but the effect of acid reflux is greater.
Adult ; Aged ; Aged, 80 and over ; Esophageal pH Monitoring ; Female ; Humans ; Hypopharynx ; Laryngopharyngeal Reflux/epidemiology* ; Male ; Middle Aged ; Respiratory System

Humans ; Hypopharynx ; Immunoglobulin G ; Respiratory System