Discussion
The most common complications/adverse effects of HEMII-pH consist of
nose pain, runny nose, nose bleeding, throat pain/discomfort, chest
pain, cough, headache and dysphagia [4]. Catheter displacement is
known to be a potential problem that may impair the test accuracy
[5]. The pH probe movements usually depend on the body position,
bolus size and composition and talking [5]. During swallowing, the
pH probe began by ascending 0.5-2.0 cm then returned to the baseline
position. A study found that, for 48 swallows, the ascending oscillation
was followed by a descending oscillation of up to 2.0 cm before
returning to baseline; the pH probe movements could account for the
variation in results and reproducibility of simultaneous esophageal
pH-monitoring. In this paper, we reported two rare complications of
HEMII-pH characterized by probe movements related to retrograde
esophageal peristaltic events (belching and vomiting). Regarding the
features of the first patient, hiatal hernia could be a favoring factor.
To the best of our knowledge, this kind of complication was never
reported. Otolaryngologist who performed in-office HEMII-pH testing has
to be aware about the risk of folded probe or probe node in patients
with vomiting events or belching. The removal of the probe has to be
cautious in patients with a clinical suspicion of probe movements
regarding the theoretical risk of nasal traumatism.