Correlation of pH Probe-Measured Laryngopharyngeal Reflux With Symptoms and Signs of Reflux Laryngitis

• Published in: The Laryngoscope 2002-12, Vol.112 (12), p.2192-2195
• Main Authors: Noordzij, J. Pieter, Khidr, Aliaa, Desper, Ellen, Meek, Robert B., Reibel, James F., Levine, Paul A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; gastroesophageal reflux disease; Heartburn - etiology; hoarseness; Humans; Hydrogen-Ion Concentration; Ion-Selective Electrodes; Laryngitis - diagnosis; Laryngitis - etiology; laryngopharyngeal reflux; Male; Medical sciences; Middle Aged; Non tumoral diseases; Other diseases. Semiology; Otorhinolaryngology. Stomatology; pH probe; Prospective Studies; Reflux laryngitis; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200212000-00013

Objectives/Hypothesis Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed. Study Design Prospective clinical trial. Methods Forty‐two consecutive, nonsmoking patients with one or more reflux laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24‐hour, dual‐sensor pH probe testing. Twenty‐nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, “lump‐in‐throat” sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interarytenoid irregularity. Results Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes). Conclusions Throat clearing was the most intense symptom in the present group of patients with proven reflux laryngitis. Dual‐sensor pH probe testing could not predict the severity of patient's reflux laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.