title: Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy.
abstract: OBJECTIVE
  To determine if degree of lingual tonsil hypertrophy (LTH) correlates with pharyngeal reflux.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Patients with flexible laryngoscopic evidence of LTH were included. Degree of LTH was graded mild, moderate, or severe by two otolaryngologists blinded to pH study results. Three-sensor pH study results were correlated to LTH grade.
  
  
  RESULTS
  Nineteen patients were included (five with mild LTH, eight with moderate LTH, and six with severe LTH). Nasopharyngeal reflux (NPR) events <pH4 were found in four of six severe LTH patients but no mild or moderate LTH patients (P = 0.006). All severe LTH patients had NPR events <pH5, compared with only 4 of 11 mild or moderate LTH patients (P = 0.017). At the UES, 4 of 6 severe LTH patients had pathologic reflux, compared with 4 of 13 mild or moderate (P = 0.025). Interobserver reliability calculated by Cohen's kappa was excellent (0.92).
  
  
  CONCLUSIONS
  Our study shows a continuum of increasing pharyngeal reflux with higher LTH severity. Severe LTH may be a reliable physical sign of pharyngeal reflux, especially NPR.
authors: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Emory University, Atlanta, GA 30322, USA. jdelgaudio@emroyhealthcare.org
authors: John M
authors: JM
authors: DelGaudio
authors: Iman
authors: I
authors: Naseri
authors: Justin C
authors: JC
authors: Wise
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000473:pathology*; D010608:Pharyngeal Diseases / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014059:Tongue