title: Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux.
abstract: OBJECTIVE
  To characterize the videoendoscopic laryngeal findings in patients with a prior established diagnosis of laryngopharyngeal reflux disease (LPR) as the sole etiology for their chief complaint of hoarseness. We hypothesized that many, if not all, of these patients would present with discrete laryngeal pathology, divergent from LPR.
  
  
  METHODS
  Prospective, nonintervention.
  
  
  METHODS
  Patients presenting to a tertiary laryngology practice with an established diagnosis of LPR as the sole etiology of their hoarseness were included. All subjects completed the Voice Handicap Index and Reflux Symptom Index, in addition to a questionnaire regarding their reflux diagnosis and prior treatment. Laryngoscopic examinations were reviewed by the laryngologist caring for the patients. Reliability of findings was assessed by interpretation of videoendoscopic findings by three outside laryngologists not involved in the care of the patients.
  
  
  RESULTS
  Laryngeal pathology distinct from LPR was identified in all 21 patients felt to be causative of the chief complaint of dysphonia. Specifically, the most common findings were benign mucosal lesions and vocal fold paresis (29% each), followed by muscle tension dysphonia (14%). Two patients were found to have vocal fold leukoplakia, of which one was confirmed to be a microinvasive carcinoma upon removal.
  
  
  CONCLUSIONS
  LPR may be overdiagnosed; other etiologies must be considered for patients with hoarseness who fail empiric LPR treatment.
  
  
  METHODS
  4.
authors.affiliation: New York University Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rafii
authors.forename: Salvatore
authors.initials: S
authors.lastname: Taliercio
authors.forename: Stratos
authors.initials: S
authors.lastname: Achlatis
authors.forename: Ryan
authors.initials: R
authors.lastname: Ruiz
authors.forename: Milan R
authors.initials: MR
authors.lastname: Amin
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Branski
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006685:Hoarseness / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012017:Referral and Consultation; D018570:Risk Assessment; D012720:Severity of Illness Index; D014741:Video Recording; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: Voice; laryngopharyngeal reflux disease; voice disorder