The Accuracy of the Laryngopharyngeal Reflux Diagnosis: Utility of the Stroboscopic Exam.
To determine the prevalence and also accuracy of the laryngopharyngeal reflux (LPR) referring diagnosis and to determine the most useful clinical tool in arriving at the final diagnosis in a tertiary laryngology practice.



Case series with planned data collection.



Six tertiary academic laryngology practices.



We collected referring diagnosis and demographic information, including age, sex, ethnicity, referring physician, and whether or not patients had prior flexible laryngoscopy for 1077 patients presenting with laryngologic complaints from January 2010 and June 2013. Final diagnosis after the referred laryngologist's examination and the key diagnostic test used was then recorded.



Of 1077 patients, 132 had a singular referring diagnosis of LPR. Only 47 of 132 patients (35.6%) had LPR confirmed on final primary diagnosis. Transnasal flexible laryngoscopy confirmed this in 27 of 47 (57.4%) patients. Eighty-five of 132 (64.4%) had a different final diagnosis than LPR. Sixty-five of 85 (76.5%) of these alternative pathologies were diagnosed with the aid of laryngeal stroboscopy.



LPR appears to be an overused diagnosis for laryngologic complaints. For patients who have already had transnasal flexible laryngoscopic exams prior to their referral, laryngeal stroboscopy is the key diagnostic tool in arriving at the correct diagnosis.
NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA mark.andrew.fritz@gmail.com.
Mark A
MA
Fritz
NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
Michael J
MJ
Persky
Department of Population Health (Biostatistics), New York University School of Medicine, New York, New York, USA.
Yixin
Y
Fang
Department of Otolaryngology, University of Texas Health Science Center, San Antonio, Texas, USA.
C Blake
CB
Simpson
NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
Milan R
MR
Amin
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Lee M
LM
Akst
Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, USA.
Gregory N
GN
Postma
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D049489:Stroboscopy / Q000379:methods*
flexible laryngoscopy; laryngopharyngeal reflux; reflux; stroboscopy