Prospective Study of Upper Esophageal Sphincter Assist Device for Treating Extraesophageal Reflux

Stacey L. Slivers*, Michael F. Vaezi, Nimish B. Vakil, Alan R. Raymond, Michael J. Schmalz, Tina Higginbotham, James S. Miller and Nicholas T. Maris

Prospective Study of Upper Esophageal Sphincter Assist Device for Treating Extraesophageal Reflux.

Extraesophageal reflux is a heterogeneous disease, caused by the regurgitation of gastroduodenal contents into the larynx. The Upper Esophageal Sphincter Assist Device is a novel medical device designed to prevent gastroduodenal reflux into the
laryngopharynx. A multicenter prospective study assessing safety and effectiveness of the UES Assist
Device in patients with EER.

Patients with Reflux Symptom Index>13 were enrolled. The device was fit and adjusted to at least 20 mmHg applied external cricoid pressure. The primary effectiveness end-point was reduction in RSI at 4-weeks compared to baseline. 36-Item Short Form Health Survey or SF-36® Health Survey (SF-36), patient and physician satisfaction, and Functional
Outcomes of Sleep Questionnaire were secondary end-points. Safety was based on reported adverse reactions.

Eighty-nine of 95 patients completed the study [mean(Standard Deviation (SD)) age=48.8(+/-13.7); mean(SD) Body Mass Index (BMI)=25.5(+/-4.2); 69.5% female, 81.1% Caucasian]. Most common troublesome symptoms included chronic cough (21.3%) and excess mucus/post nasal drip (20.2%). There was a significant (p<0.0001) reduction in median
(Intelligence Quotient (IQ)) RSI at 2- and 4-weeks [12.5(8.0-20.0) and 10.0(5.8-16.5), respectively] compared to baseline [25.6(21.0-30.0)].

Eighty-two percent (82%) reported improvement greater than 25% with 30.1% having an improvement of 75% or more. 84.7% of patients and 95.2% of providers reported satisfaction. Adverse events were generally mild and transient
with no withdrawals due to adverse events.

Extraesophageal reflux disease represents a wide spectrum of manifestations, mainly related with the upper and
the lower respiratory system, such as laryngitis, asthma, chronic
obstructive pulmonary disease, cough, hoarseness, postnasal
drip disease-sinusitis, otitis media, recurrent pneumonia and laryngeal cancer.

Otolaryngol Open J. 2016; 2(1): 31-38. doi: 10.17140/OTLOJ-2-109

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