Diagnostic sensitivity and specificity of laryngoscopic signs of reflux laryngitis.
OBJECTIVE
To assess the diagnostic sensitivity and specificity of the laryngoscopic signs of reflux laryngitis.


METHODS
Using original quantitative evaluation system, the laryngoscopic signs of 108 patients with reflux laryngitis and 90 healthy people were subjected to comparative analysis in this study. Summing up all evaluations of laryngeal changes, laryngoscopic reflux index was proposed.


RESULTS
Mucosal lesions and edema of vocal cords along with mucosal lesions of the interarytenoid notch were found to be most significant for diagnostics of reflux laryngitis. Presence of mucosal lesions of the interarytenoid notch (roughness, hypertrophy, keratosis, granuloma) increases the odds ratio to attribute the patient to the reflux laryngitis patient group 21 times (OR=21.32, 95% CI 4.38-103.93; P<0.001). Mucosal lesions (hypertrophy, keratosis, granuloma) and edema of vocal cords were determined as the most sensitive and rather specific laryngoscopic signs. Roughness and grade II hypertrophy of interarytenoid notch were found to be the most specific (98%) and sensitive (56%) laryngoscopic signs of reflux laryngitis. Abnormal values of laryngoscopic reflux index (higher than 5 points) reflect a diagnostic sensitivity of 96% and specificity of 97% differentiating patients with reflux laryngitis from healthy persons.


CONCLUSIONS
Mucosal lesions and edema of vocal cords along with mucosal lesions of the interarytenoid notch are found to be the most significant laryngoscopic signs for diagnostics of reflux laryngitis. Laryngoscopic reflux index was found to be the most sensitive and specific diagnostic criterion for reflux laryngitis.
Pribuisiene
Rūta
R
Department of Otorhinolaryngology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania. ruta-prib@takas.lt
Uloza
Virgilijus
V
Kupcinskas
Limas
L
D000328:Adult; D003627:Data Interpretation, Statistical; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007819:Laryngeal Edema / Q000175:diagnosis; D007820:Laryngeal Mucosa; D007827:Laryngitis / Q000175:diagnosis* / Q000209:etiology; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012372:ROC Curve; D012680:Sensitivity and Specificity; D049489:Stroboscopy; D014741:Video Recording; D014827:Vocal Cords