The association between laryngeal pseudosulcus and laryngopharyngeal reflux.
BACKGROUND
A pattern of edema on the ventral surface of the vocal fold, called pseudosulcus vocalis, was described in 1995. It refers to infraglottic edema extending from the anterior commissure to the posterior larynx. It can be differentiated from sulcus vergeture, which is caused by adhesion of the vocal fold epithelium to the vocal ligament. Although it has been related to laryngopharyngeal reflux (LPR), this has not been thoroughly investigated.


OBJECTIVE
Our goal was to evaluate the association between pseudosulcus and LPR.


METHODS
Thirty patients with a clinical diagnosis of LPR confirmed by double-probe pH monitoring and 30 controls without LPR were enrolled. The prevalence of pseudosulcus was determined with fiberoptic laryngoscopy.


RESULTS
Seventy percent (21 of 30) of patients with lpr and 30% (9 of 30) of controls had pseudosulcus. Patients with pseudosulcus were 2.3 times more likely to have pH-documented LPR (95% confidence interval 1.3-4.2). The sensitivity and specificity of pseudosulcus in the diagnosis of LPR are 70% and 77%, respectively.


CONCLUSIONS
Pseudosulcus is highly correlated with pH-documented LPR (P < 0.001). The presence of pseudosulcus is suggestive of LPR.
Belafsky
Peter C
PC
Center for Voice Disorders of Wake Forest University, Winston-Salem, NC 27157-1034, USA.
Postma
Gregory N
GN
Koufman
James A
JA
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007819:Laryngeal Edema / Q000150:complications* / Q000175:diagnosis; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity