Reflux Testing for ENT and SLP:
Diversatek Healthcare ZepHr® and
PatCom Introducer
Otolaryngologists (ENT) diagnose and Speech Language Pathologists (SLP) describe reflux and reflux diseases as part of their regular practice. Laryngopharyngeal reflux (LPR, also known as reflux laryngitis), extra-esophageal reflux and symptoms related to gastroesophageal reflux disease (GERD) are very common in today’s society and 20% or more of the population in North America is affected by it. The evaluation is done with the help of endoscopic equipment such as the PatCom 3.4mm nasopharyngoscope and PatCom FEES system.
24 hour pH monitoring is one of the gold standards in reflux testing. It adds a quantitative measure to the evaluation by detecting pH levels both in the pharynx as well as the distal esophagus. Impedance measurements along the esophagus add additional information about the behavior of acidic reflux as well as non-acidic reflux.
The combination of the Diversate Healthcare ZepHr® pH system with the PatCom Introducer for quick and easy probe placement make it easy for Ear Nose and Throat (ENT) physicians as well as Speech Pathologists (SLP) to conduct reflux testing as part of their private practice and in the hospital.
The Probe Placement
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Avoiding the touch of sensitive structures during placement
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Navigation into esophagus under visualization instead of blindly
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Visual confirmation of successful placement inside the esophagus
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Increased patient comfort leads to increased patient compliance and satisfaction
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Easy placement speeds up procedure time and improves workflow
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Works with any nasopharyngoscope with OD 3.6mm and smaller
Diversatek Healthcare ZepHr® reflux equipment
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Easy set up within minutes
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3 programmable buttons for symptoms
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Buttons for meals and supine positioning
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Easy transfer of data to computer via SD card
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Computer software for automated analysis included
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Calibration Kit for precice measurement included
The Diversatek Healthcare ZepHr® standard set up consists of a reusable reflux testing recorder, a calibration kit with buffer solution and accessories to carry the reflux recorder as well as transfer results to a computer. One-time-use probes with different sensor configurations are used based on the clinical requirements.
The 24h pH monitoring recorder itself features a small size and lightweight design with easy-to-use interface. Three large easy to identify programmable symptom buttons are used by the patient to digitally record whenever they are experiencing one of their reflux symptoms. Additional dedicated buttons on the device record upright and recumbent patient position and meal times. A back light can be turned on to be able to operate the pH recorder in the night. All data is conveniently stored on a SD card making it easy to transfer study results to a computer.
The 24 hour pH monitoring probes come in three sizes for Pharyngeal Reflux Detection to meet a variety of esophageal lengths. They measure the number of incidences and frequency of distal, proximal, and pharyngeal reflux events, both acid and nonacid. They correlate patient symptoms, such as cough, with reflux events. The uniquely designed ZepHr® LPR Probes use impedance to identify retrograde reflux and pH sensors to differentiate acid and nonacid reflux events. Small in diameter, Diversatek Healthcare ZepHr® probes are made from specially-formulated polyurethane, which softens in response to body temperature to optimize ease of insertion and enhance patient comfort.
Analysis and Report
Zvu® Functional GI Software gives the complete picture for reflux diagnostics. The integrated AutoSCAN® does the analysis for the end user and gives recommendations for a most convenient and efficient work flow.
The pH monitoring software automatically detects and analyzes full column reflux and hypopharyngeal events. It automatically adjusts normal values whether the study is performed on or off PPIs. Simplified software controls allow easy transitioning between color and conventional views, including impedance. Customizable reports and multiple report formats are available and will be set up based on clinical requirements and visual preferences.
The reflux testing software includes automated analysis of Mean Nocturnal Baseline Impedance (MNBI), and calculates both DeMeester and Boix-Ochoa composite scores. Naturally Zvu® Functional GI Software includes the latest consensus guidelines.
Training And Education
Representatives of the American Board of Swallowing and Swallowing Disorders (AB-SSD) and American Speech-Language-Hearing Association (ASHA) Special Interest Group (SIG) 13: Swallowing and Swallowing Disorders (Dysphagia) developed a tutorial on best practice guidelines for FEES. In this tutorial, they suggest 6 steps to obtain FEES competency.
- Attend and complete an ASHA CE Approved External FEES Course or Internal Facility Mentored Training
- Take and Complete an Exam Based on the Content of the Course
- Passing and Handling Scope: Healthy Volunteers
- Passing the Scope and Performing a FEES Exam: Patients
- Mentor Assessment
- Indirect Supervision: Final Step
With these recommended steps in mind, PatCom Medical Inc. collaborates with the world leaders in FEES education to assist you with training and competency. Any new customer receives free access to a basic FEES course included in the new equipment purchase. In addition to this, further competency training and master classes are available on demand. Education is such an essential part of FEES that PatCom Medical will support you in this regard on an ongoing basis.
Link for the article:
Langmore, Susan E et al. “Tutorial on Clinical Practice for Use of the Fiberoptic Endoscopic Evaluation of Swallowing Procedure With Adult Populations: Part 1.” American journal of speech-language pathology vol. 31,1 (2022): 163-187. doi:10.1044/2021_AJSLP-20-00348
One of the the main reasons PatCom Medical Inc. was established is the desire to commit to a level of customer service that goes above and beyond what others do. The PatCom service concept provides the support that ensures our customers are able to perform their own work without interruption. It this the underlying understanding of everyone at PatCom to make our customer’s problems ours to solve that sets us apart.
As responsiveness is a key element of good service we offer support 7 days a week by phone, email and text. We offer remote access service free of charge where we have the ability to take control of your system’s computer to solve any software related issues within minutes.
The Service
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Pledge to raise industry standard of customer service to new levels
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7 day technical support by phone, email and text
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Remote access software service included
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Free loaner during repair
What is Acid Reflux?
When the lower esophageal sphincter (LES) is closed, it prevents acid and stomach contents from traveling backwards from the stomach. Acid reflux occurs when the LES relaxes at the wrong time, making it possible for stomach acid content to back up into the esophagus. This can cause a number of different symptoms in the esophagus but also as high up as the larynx and pharynx. Laryngopharyngeal reflux (LPR) is a condition in which acid from the stomach moves up the esophagus and gets to the throat. LPR symptoms include sore throat, cough and an irritated larynx. Lifestyle changes often times offer the best treatment outcome.
What is 24h pH monitoring?
There are very few side effects of esophageal pH monitoring. Although there may be mild discomfort in the back of the throat while the catheter is in place, particularly during swallows, the majority of patients have no difficulty eating, sleeping, or going about their daily activities.
Reflux testing with esophageal 24-hour pH/impedance reflux monitoring is a quantitative measurement. It measures the amount of reflux (both acidic and non-acidic) in the esophagus and larynx/pharynx during a 24-hour tp 48h period. It also assesses whether the patient’s symptoms are correlated with the reflux or not.
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