Reflux Symptom and Sign Instrument: A New Instrument to Diagnose Pediatric Laryngopharyngeal Reflux

Abstract

Introduction: Laryngopharyngeal reflux (LPR) is commonly found in children, usually connected to airway problems. LPR remains controversial as no standardized diagnostic instrument. Diagnostic tools available have been validated mostly in adults, i.e. Reflux Symptom Index (RSI) and reflux finding score (RFS). Objective: The objective of the study was to obtain a cost-effective, simple, convenient, noninvasive instrument with good diagnostic outcome. Methods: We compared RSI and RFS with esophageal double probe 24-h pHmetry results. A total of 29 children were recruited, aged 5–18 years. The inclusion criterion was phlegmy throat, frequent odynophagia, sensation of a lump in the throat, throat clearing, choking episodes, hoarseness, and chronic cough for at least 4 weeks. The subjects underwent nasopharyngolaryngoscopy and pHmetry insertion. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using three scenarios. Results: The Reflux Symptoms-Sign Instruments (RSII), consisting of frequent throat clearing, annoying cough, choking, vocal cords abnormalities, and subglottic edema has a cutoff score of 4 and demonstrated 75% sensitivity, 77% specificity, 80% PPV, and 71% NPV. Conclusions: The RSII has shown a good diagnostic result in diagnosing LPR in children.