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.