Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis.
OBJECTIVE
Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed.


METHODS
Prospective clinical trial.


METHODS
Forty-two consecutive, nonsmoking patients with one or more reflux laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24-hour, dual-sensor pH probe testing. Twenty-nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, "lump-in-throat" sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interarytenoid irregularity.


RESULTS
Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes).


CONCLUSIONS
Throat clearing was the most intense symptom in the present group of patients with proven reflux laryngitis. Dual-sensor pH probe testing could not predict the severity of patient's reflux laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.
Noordzij
J Pieter
JP
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, USA. jpnoordzij@pol.net
Khidr
Aliaa
A
Desper
Ellen
E
Meek
Robert B
RB
Reibel
James F
JF
Levine
Paul A
PA
D000328:Adult; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006356:Heartburn / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017736:Ion-Selective Electrodes; D007827:Laryngitis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies