scholarly journals Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population

2021 ◽  
Vol 9 (1) ◽  
pp. 25-25
Author(s):  
Jun-Yao Wang ◽  
Tao Peng ◽  
Li-Li Zhao ◽  
Gui-Jian Feng ◽  
Yu-Lan Liu
Keyword(s):  
Chinese Population ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Index

The Value of Routine pH Monitoring in the Diagnosis and Treatment of Laryngopharyngeal Reflux

2012 ◽  
Vol 146 (6) ◽  
pp. 952-958 ◽  
Author(s):  
Michael Friedman ◽  
Craig Hamilton ◽  
Christian G. Samuelson ◽  
Kanwar Kelley ◽  
Renwick Taylor ◽  
...  
Keyword(s):  
Predictive Value ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Linear Regression Analysis ◽  
Tertiary Care ◽  
Case Series ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Significant Difference

Objective. To assess the need for pH testing in diagnosing laryngopharyngeal reflux (LPR). Study Design. Case series with planned data collection. Setting. Tertiary care center. Subjects and Methods. On the basis of symptoms and/or abnormal endoscopic findings, more than 500 patients underwent 24-hour pharyngeal pH testing at a single center (using the Dx-pH probe) between January 2009 and June 2011. A total of 163 patients not on proton-pump inhibitors at the time of study and with complete data available for analysis (pH results, body mass index, smoking status, pretest reflux symptom index) were divided into 2 groups by positive (n = 70) and negative (n = 93) Ryan Score. The Reflux Symptom Index (RSI) was compared between groups and assessed overall against Ryan Score parameters at different pH thresholds. The diagnostic utility of an RSI ≥ 13 for prediction of Ryan Score was assessed. Results. No significant difference in RSI was seen between Ryan-positive (17.50 ± 11.47) and Ryan-negative (14.95 ± 11.43) patients ( P = .161). Overall, RSI correlated poorly with percentage time spent below pH thresholds 6.5, 6.0, 5.5, and 5.0 and upright and supine Ryan parameters at these thresholds (as determined by linear regression analysis). The sensitivity, specificity, positive predictive value, and negative predictive value of RSI ≥ 13 for Ryan positivity were 55.7%, 47.3%, 44.3%, and 58.7%, respectively. Conclusion. Our findings show that in our population of otolaryngology patients, the diagnosis of LPR cannot be reliably made on the basis of symptoms alone. Diagnosis, and in particular treatment decisions, should ideally be made on the basis of a combination of symptoms, signs, and confirmatory testing.

Empirical treatment with pantoprazole as a diagnostic tool for symptomatic adult laryngopharyngeal reflux

2011 ◽  
Vol 125 (5) ◽  
pp. 502-508 ◽  
Author(s):  
M Masaany ◽  
M B Marina ◽  
W P Sharifa Ezat ◽  
A Sani
Keyword(s):  
Predictive Value ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Symptom ◽  
Empirical Treatment ◽  
Double Blind Study ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Double Blind ◽  
Symptom Index

AbstractObjective:To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.Study design:This was a prospective, double-blind study.Subjects and methods:Fifty-five patients with either a Reflux Symptom Index of more than 13 or a Reflux Finding Score of more than 7 were enrolled. All patients underwent 24-hour, double-probe pH monitoring before commencing pantoprazole 40 mg twice daily; both investigators and patients were blinded to pH monitoring results. The Reflux Symptom Index and Reflux Finding Score were reassessed during the second, third and fourth month of follow up.Results:The sensitivity of empirical pantoprazole treatment in diagnosing laryngopharyngeal reflux was 92.5 per cent. The specificity was 14.2 per cent, the positive predictive value 86 per cent and the negative predictive value 25 per cent. There was significant reduction in the total Reflux Symptom Index and Reflux Finding Score after the second, third and fourth month of treatment. There was no correlation between laryngopharyngeal reflux and body mass index.Conclusion:Our results suggest that intensive empirical treatment with proton pump inhibitors is effective in diagnosing laryngopharyngeal reflux.

scholarly journals The application of 24-hour pharyngeal pH-monitoring and Reflux Finding Score and Reflux Symptom Index questionnaires in the diagnostics of laryngopharyngeal reflux

2019 ◽  
Vol 14 (4) ◽  
pp. 274-282
Author(s):  
Elżbieta Włodarczyk ◽  
Beata Miaśkiewicz ◽  
Danuta Raj-Koziak ◽  
Agata Szkiełkowska ◽  
Piotr Skarżyński ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Symptom ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index

Association between Laryngeal Pepsin Levels and the Presence of Vocal Fold Polyps

2016 ◽  
Vol 156 (1) ◽  
pp. 144-151 ◽  
Author(s):  
Lu Wang ◽  
Jia-Jie Tan ◽  
Ting Wu ◽  
Rui Zhang ◽  
Jia-Nuan Wu ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Symptom ◽  
Healthy Controls ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Predictive Values ◽  
Laryngeal Mucosa

Objective To determine whether pepsin, the main component of refluxed gastric contents, is significantly associated with vocal fold polyps and to evaluate the diagnostic value of pepsin in vocal fold polyps’ tissues. Study Design Cross-sectional study. Setting Nanfang Hospital of Southern Medical University. Subjects and Methods The study included 32 patients with vocal fold polyps and 16 healthy controls between 2011 and 2012. Reflux symptom index and reflux finding score assessments, 24-hour combined multichannel intraluminal impedance and pH monitoring, and biopsy of the vocal fold polyp tissues or posterior laryngeal mucosa (healthy controls) for immunohistochemical pepsin staining were performed. Results The expression of pepsin was significantly higher in patients with vocal fold polyps than in controls (28/32, 75% vs 5/16, 31.25%; P < .001). The pepsin levels were significantly positively correlated with upright position pharyngeal acid reflux and esophageal reflux parameters adjusted by age. Based on pepsin staining data, the sensitivity and negative predictive values of 24-hour pH monitoring, the reflux symptom index, and the reflux finding score were 70% to 84.62%, whereas their specificity and positive predictive values were relatively low (20%-31.58%). Conclusion Pepsin reflux may be a risk factor for vocal fold polyps formation. In addition, pepsin immunohistochemical analysis of polyp biopsy samples appears to be a more sensitive and effective test for diagnosing laryngopharyngeal reflux than the reflux symptom index, the reflux finding score, and 24-hour pH monitoring in a clinical setting.

scholarly journals Deteksi pepsin pada penderita refluks laringofaring yang didiagnosis berdasarkan reflux symptom index dan reflux finding score

2011 ◽  
Vol 41 (2) ◽  
pp. 121
Author(s):  
Yunida Andriani ◽  
Muhammad Amsyar Akil ◽  
Masyita Gaffar ◽  
Abdul Qadar Punagi
Keyword(s):  
Gold Standard ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Symptom ◽  
Diagnostic Tools ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Double Probe ◽  
Contact Ulcer

Background: It is estimated that more than 50% of patients with voice disorders who come fortreatment are caused by laryngopharyngeal reflux (LPR). LPR has been implicated in the etiology ofmany laryngeal disorders including subglottic stenosis, laryngeal carcinoma, laryngeal contact ulcer,laryngospasm and vocal nodule on the vocal cords. Ambulatory 24 hour double-probe (pharyngeal andesophageal) pH monitoring is the gold standard examination for diagnosing LPR, but it is still far fromideal criteria.The assessment of pepsin in airway secretions could be used as a sensitive diagnosticmarker of LPR because pepsin is not synthesized by any type of airway cells. Purpose: The aim ofthis study was to detect the presence of pepsin on laryingopharyngeal reflux patients which diagnosedbased on reflux symptom index (RSI) dan reflux finding score (RFS) at Wahidin Sudirohusodo Hospital,Makassar. Methods: This is a comparative quantitative study. We performed RSI and RFS examinationson 51 samples, followed by saliva pepsin detection using ELISA method on 48 samples, then analyzed withSpearman’s Rho test. Result: RSI score >13 was found in 48 samples (94,12%)  and RFS score >7 wasin 51 samples (100%).    Pepsin was detected on all sputum samples, however there was no significant relationship betwen RSI and RFS scoring with the level of pepsin in saliva (p>0.01). Conclusion: Pepsin was detected on saliva of patients with laringopharyngeal reflux who was diagnosed based on RSI andRFS. We concluded that RSI and RFS can be used as diagnostic tools for LPR. Keywords: laringopharyngeal reflux, reflux symptom index, reflux finding score, pepsin Abstrak :  Latar belakang: Diperkirakan lebih dari 50% pasien dengan gangguan suara yang datang berobatke dokter THT diakibatkan oleh refluks laringofaring (RLF). Diduga RLF berperan pada patogenesissejumlah kelainan pada laring, termasuk stenosis subglotik, karsinoma laring, laryngeal contact ulcers,laringospasme dan vokal nodul pada pita suara. Pemeriksaan ambulatory 24 hour double-probe pHmonitoring merupakan gold standard untuk mendiagnosis RLF, namun pemeriksaan ini masih jauh darikriteria ideal. Menentukan adanya pepsin pada sekret saluran napas merupakan petanda diagnostik yangsensitif untuk RLF karena pepsin tidak dihasilkan oleh sel apapun dalam saluran napas. Tujuan: Penelitianini bertujuan mendeteksi keberadaan pepsin pada penderita refluks laringofaring yang didiagnosisberdasarkan refluks symptom index (RSI) dan reflux finding score (RFS). Metode: Jenis penelitian iniadalah komparatif kuantitatif. Dilakukan pemeriksaan RSI dan RFS pada 51 percontoh dan dilanjutkandengan pemeriksaan pepsin saliva menggunakan metode ELISA pada 48 percontoh lalu dilakukan ujiSpearman’s Rho. Hasil: Skor RSI >13 sebanyak 48 percontoh (94,12%) dan skor RFS >7 sebanyak 51percontoh (100%). Pepsin terdeteksi pada saliva semua percontoh. Tidak ada hubungan yang bermaknaantara skoring RSI dan RFS dengan kadar pepsin pada saliva (p>0,01). Kesimpulan: RSI dan RFS dapatdigunakan dalam menegakkan diagnosis RLF. Kata kunci: refluks laringofaring, reflux symptom index, reflux finding score, pepsin

scholarly journals Correlation between reflux symptom index and reflux finding score in patients with laryngopharyngeal reflux: Our experience

2016 ◽  
Vol 3 ◽  
pp. 13-17
Author(s):  
Deepthi Satish ◽  
H. C. Badari Datta ◽  
B. V. Manjula ◽  
Brinda A. Poojari ◽  
Bhaskar Reddy Molluru
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Reflux Symptom ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index

The effect of anti-reflux treatment on subjective voice measurements of patients with laryngopharyngeal reflux

2013 ◽  
Vol 127 (6) ◽  
pp. 590-594 ◽  
Author(s):  
T J Beech ◽  
G Campbell ◽  
A L McDermott ◽  
A J Batch
Keyword(s):  
Proton Pump ◽  
Speech Therapy ◽  
Laryngopharyngeal Reflux ◽  
Proton Pump Inhibitor Therapy ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Scale ◽  
Symptom Index ◽  
Scale Scores ◽  
The Impact

AbstractObjective:To assess the impact of anti-reflux treatment and speech therapy on subjective voice measurements of patients with laryngopharyngeal reflux.Methods:This paper reports a prospective study of patients seen in a voice clinic over a three-year period who were being treated for laryngopharyngeal reflux. Patients were assessed at presentation using the reflux symptom index and voice symptom scale, and were reassessed at three months and six months post-treatment. Treatment entailed twice daily proton pump inhibitor therapy and speech therapy.Results:The study comprised 74 patients. The reflux symptom index and voice symptom scale scores significantly improved following treatment at both three and six months. There was a correlation between improved reflux symptom index scores and improved voice symptom scale scores.Conclusion:Treatment of laryngopharyngeal reflux with twice daily proton pump inhibitors and speech therapy resulted in improved subjective voice measurements for patients.

Non-voice-related throat symptoms: comparative analysis of laryngopharyngeal reflux and globus pharyngeus scales

2010 ◽  
Vol 125 (1) ◽  
pp. 59-64 ◽  
Author(s):  
R A Cathcart ◽  
N Steen ◽  
B G Natesh ◽  
K H Ali ◽  
J A Wilson
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Principal Component ◽  
Symptom Assessment ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Similar Symptom ◽  
Postnasal Drip ◽  
Throat Symptom ◽  
Oblimin Rotation

AbstractBackground:This study calculated the comparability of two throat symptom assessment scales devised to evaluate either laryngopharyngeal reflux or globus.Setting:United Kingdom hospital out-patient departments.Method:A total of 334 subjects, with and without throat symptoms, completed the Reflux Symptom Index and/or the Glasgow and Edinburgh Throat Scale. The following were calculated for the resultant data: Cronbach's α coefficient, principal component analysis, Kaiser normalisation, varimax and oblimin rotation, and eigenvalues.Results:Analysis of data from the Reflux Symptom Index and the Glasgow and Edinburgh Throat Scale revealed clearly similar symptom domains regarding (1) coughing and blockage, and (2) globus or postnasal drip or throat-clearing, as did combined analysis of their amalgamated items. Both instruments had good overall internal consistency (α = 0.75 and 0.81, respectively). The ‘heartburn or reflux’ item in the Reflux Symptom Index mapped poorly to each underlying factor.Discussion:The most commonly used laryngopharyngeal reflux and globus assessment questionnaires appear to detect very similar symptom clusters. The management of throat disorders may previously have been over-reliant on the presenting pattern of throat symptoms. Our findings indicate a need to revisit the traditional clinical classification of throat symptoms.

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