Pachydermia is not diagnostic of active laryngopharyngeal reflux disease.
OBJECTIVE
To determine the change in pachydermia/posterior commissure hypertrophy in patients with laryngopharyngeal reflux disease (LPR) on long-term acid-suppressive therapy.


METHODS
Retrospective chart review.


METHODS
Seventeen patients with LPR who were compliant with long-term acid-suppressive treatment and had good control of their symptoms for at least 20 months were examined. Pre- and posttreatment still laryngeal images from these patients were analyzed by five otolaryngologists blinded to patient information and were scored for pachydermia/posterior commissure hypertrophy according to the Reflux Finding Score (RFS) subset. Test-retest intraobserver reliability, intergrader correlations, as well as a paired t test for means of the data sets were then calculated.


RESULTS
There was no significant difference in the grading scores between the pre- and posttreatment group for degree of pachydermia/posterior commissure hypertrophy despite a prolonged treatment interval (mean = 32 months) (P = .25).


CONCLUSIONS
There is no statistically significant difference in the degree of pachydermia/posterior commissure hypertrophy found at diagnosis and after long-term acid suppressive therapy in patients with LPR. Therefore, it appears that pachydermia, as an isolated finding, is unreliable in determining the presence of active LPR.
Department of Otolaryngology/Head and Neck Surgery, University of Texas Health Science Center, San Antonio, TX, USA.
R Keith
RK
Hill
C Blake
CB
Simpson
Ruben
R
Velazquez
Nicole
N
Larson
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006984:Hypertrophy; D064747:Lansoprazole; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D007820:Laryngeal Mucosa / Q000187:drug effects / Q000473:pathology*; D007828:Laryngoscopy; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077402:Pantoprazole; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D013454:Sulfoxides / Q000627:therapeutic use; D016896:Treatment Outcome; D014832:Voice Disorders / Q000188:drug therapy / Q000209:etiology*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; D013454:Sulfoxides; D064747:Lansoprazole; D000077402:Pantoprazole; D009853:Omeprazole