Laryngopharyngeal Reflux in Dysphonics—Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study

Abstract

Objective To determine the prevalence of laryngopharyngeal reflux (LPR) in patients with voice disorders and to find out the efficacy of reflux symptom index (RSI) and reflux finding score (RFS) in the diagnosis. Methods This prospective analytical study was conducted on 554 patients who presented with dysphonia and symptoms suspicious of LPR. They were then subjected to clinical work up based on symptomatic history based RSI and video stroboscopic RFS scoring criteria. The results were analyzed statistically. The differences between RSI and RFS were calculated by Fisher's two sided test and the comparison between the two is calculated using kappa statistics to check the strength of agreement. Results Among 554 patients, 457 (82.4%) patients were diagnosed to have LPR based on RSI score of more than 13. Among 448 (80.8%) patients RFS score was positive. Vocal nodule (23.64%), laryngitis (22.38%) and the vocal polyp (20.03%) constitute the majority, with a female preponderance in vocal nodule. Both RSI and RFS were poor or almost absent in conditions such as spasmodic dysphonia, tremors, vocal cord palsy, hemorrhage, functional aphonia and traumatic conditions. The Pearson correlation coefficient showed a good correlation and agreement between RSI and RFS was statistically significant. Conclusion The association of LPR in patients with voice disorders is significantly high. The RSI and RFS based clinical diagnosis is reliable and valid in the diagnosis of LPR as revealed in our study. How to cite this article Sebastian S, Kolethekkat AA, Mathew J, Gowri M. Laryngopharyngeal Reflux in Dysphonics— Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study. Int J Phonosurg Laryngol 2014;4(1):5-9.