The application of 24-hour pharyngeal pH-monitoring and Reflux Finding Score and Reflux Symptom Index questionnaires in the diagnostics of laryngopharyngeal reflux

Abstract

Introduction: Twenty-four-hour oesophageal pH-monitoring is a gold standard in the diagnostics of gastroesophageal reflux (GERD); however, this examination does not always perform well in patients in whom laryngeal symptoms of reflux are observed. Aim: To test the effectiveness of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) in confirming the occurrence of laryngopharyngeal reflux (LPR). Material and methods: Eighty-two patients with symptoms suggesting the occurrence of LPR were studied. The mean age of the participants amounted to 48.79 ±12.02. The patients were asked to fill in the RSI. The pharynx was assessed using videolaryngostroboscopy and then the RSF was filled in. Next, 24-hour pharyngeal pH-monitoring was performed with the use of a Dx pH-Restech System device. All the statistical analyses were conducted with the use of the R computational environment. Results: The authors attempted to determine the reference values of the RSI and RFS questionnaires for the Polish population. For a very general approximation, normality of the distributions of the results in the RSI and RFS questionnaire can be done and an approximation mean + 2 SD can be used as a reference value. Then, for RSI the recommended cutoff limit of LPR would fluctuate, depending on the study, between 8 and 17, whereas for RFS it would be between 8 and 14. Conclusions: When used alone, RSI/RFS questionnaires do not allow an unambiguous diagnosis of LPR assessed by 24-hour pharyngeal pH-monitoring.

Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population

“…Other gastroenterologists agree with our opinion on these matters (23,24). Some researchers believe that age can affect the RSI diagnostic threshold for LPR (25), and another study using the Dx-pH system found that Ryan's scores, RSI, and RFS were poorly correlated with LPR detection (26).…”

Patient Reported Outcomes and Objective Swallowing Assessments in a Multidisciplinary Dysphagia Clinic

“…This suggests that most patients reported moderate to severe reflux symptoms at the time of their initial evaluation (Table II). However, the RSI is known to be relatively non‐specific 18 . Given the proportion of patients with known pathologic esophageal history at the time of evaluation, it is expected that the RSI will be elevated in this population.…”

The application of 24-hour pharyngeal pH-monitoring in the diagnosis of patients with pharyngeal and laryngeal complaints

“…W diagnostyce dolegliwości ze strony gardła i krtani 24-godzinna pH-metria gardłowa wydaje się użytecznym narzędziem diagnostycznym w sytuacji, kiedy zarówno dolegliwości pacjenta (np. na podstawie RSI), jak i obraz endoskopowy krtani (RFS) sugerują występowanie refluksu krtaniowo--gardłowego [15].…”