Screening Test for LPRD: History Versus Video Laryngoscopy
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ORIGINAL ARTICLE
Screening Test for LPRD: History Versus Video Laryngoscopy Prasun Mishra1 • Deeksha Agrawal1 • Purva Artham1
Received: 31 January 2020 / Accepted: 5 March 2020 Ó Association of Otolaryngologists of India 2020
Abstract Objective To find a better screening test by correlating between history and video-laryngoscopy in patients with laryngopharyngeal reflux disease. To compare the Reflux Symptom Index (RSI) and the Reflux Finding Score (RFS). Method Patients with the signs and symptoms of LPRD were scored based on RSI. Those with RSI above 13 were included in study and evaluated further by videolaryngoscopy examination and rated according to RFS. The correlation between RSI and RFS was analysed. Result Out of the 107 patients included in study 55% were females. Among these patients positive RFS score (i.e. [ 7) was seen in 58.3%. The average RSI was 18.22, and average RFS was 7.45. According to RSI the most common symptom was heartburn/indigestion (44.5%) and from RFS the most common finding was posterior commissure hypertrophy (95%). Correlation between RSI and total RFS was found to be 0.184 with a p value of 0.159 which was not significant. Conclusion LPRD is more common in females and in the middle age group. A correlation of RSI and RFS was not found to be significant suggesting that both should be used for diagnosis of LPRD instead of relying on only one. RFS and RSI are easy, quick and out patient based screening
& Prasun Mishra [email protected] Deeksha Agrawal [email protected] Purva Artham [email protected] 1
Department of ENT, Bharati Vidyapeeth Deemed to be University and Medical College, Pune, Maharashtra 411043, India
tools and when used together can be more reliable for LPRD diagnosis. Keywords LPRD Screening Videolaryngoscopy RSI RFS
Introduction Laryngopharyngeal reflux disease (LPRD) is defined as the retrograde flow of gastric contents into the larynx and pharynx leading to upper aerodigestive system symptoms like hoarseness, globus pharyngeus, dysphagia, cough, chronic throat clearing, postnasal drip, and wheezing [1]. LPRD not only has a significant negative impact on patient’s quality of life but it can also predispose to many laryngeal diseases such as reflux laryngitis, subglottic stenosis, laryngeal carcinoma, granulomas, contact ulcers and vocal nodules [2]. In 2002, Belafsky et al. published the Reflux Symptom Index (RSI), a classification of symptoms of laryngopharyngeal reflux [3]. There is wide divergence among specialists on the diagnosis of LPRD. Therefore, Belafsky et al. recently proposed the Reflux Finding Score (RFS), through videolaryngoscopic (VLS) findings, to decrease the subjectivity of diagnosis [3]. Most patients with LPRD are diagnosed clinically by history taking and examination with flexible or rigid laryngeal endoscopy [4]. Further investigations are indicated for those patients in whom the diagnosis is in doubt or those who do not respond to treatment. To minimize the under diagnosis of LPRD, this study aims to compare the Reflux Fi
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