scholarly journals Laryngopharyngeal Reflux in Dysphonics—Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study

2014 ◽  
Vol 4 (1) ◽  
pp. 5-9
Author(s):  
John Mathew ◽  
Swapna Sebastian ◽  
Arif Ali Kolethekkat ◽  
Mahasampath Gowri
Keyword(s):  
Clinical Diagnosis ◽  
Laryngopharyngeal Reflux ◽  
Pearson Correlation ◽  
Voice Disorders ◽  
Clinical Work ◽  
Kappa Statistics ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Vocal Nodule ◽  
Case Based

ABSTRACT Objective To determine the prevalence of laryngopharyngeal reflux (LPR) in patients with voice disorders and to find out the efficacy of reflux symptom index (RSI) and reflux finding score (RFS) in the diagnosis. Methods This prospective analytical study was conducted on 554 patients who presented with dysphonia and symptoms suspicious of LPR. They were then subjected to clinical work up based on symptomatic history based RSI and video stroboscopic RFS scoring criteria. The results were analyzed statistically. The differences between RSI and RFS were calculated by Fisher's two sided test and the comparison between the two is calculated using kappa statistics to check the strength of agreement. Results Among 554 patients, 457 (82.4%) patients were diagnosed to have LPR based on RSI score of more than 13. Among 448 (80.8%) patients RFS score was positive. Vocal nodule (23.64%), laryngitis (22.38%) and the vocal polyp (20.03%) constitute the majority, with a female preponderance in vocal nodule. Both RSI and RFS were poor or almost absent in conditions such as spasmodic dysphonia, tremors, vocal cord palsy, hemorrhage, functional aphonia and traumatic conditions. The Pearson correlation coefficient showed a good correlation and agreement between RSI and RFS was statistically significant. Conclusion The association of LPR in patients with voice disorders is significantly high. The RSI and RFS based clinical diagnosis is reliable and valid in the diagnosis of LPR as revealed in our study. How to cite this article Sebastian S, Kolethekkat AA, Mathew J, Gowri M. Laryngopharyngeal Reflux in Dysphonics— Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study. Int J Phonosurg Laryngol 2014;4(1):5-9.

scholarly journals Association Between Voice Handicap Index and Reflux Symptom Index: A cross-sectional study of undiagnosed general and teacher cohorts in Saudi Arabia

2018 ◽  
Vol 18 (3) ◽  
pp. 350 ◽  
Author(s):  
Rawan Alanazi ◽  
Ahmed Alrahim ◽  
Sara Bayounos ◽  
Abdulrahman Al-Ghuwainem ◽  
Mohammad H. Al-Bar
Keyword(s):  
Saudi Arabia ◽  
General Population ◽  
Response Rate ◽  
Laryngopharyngeal Reflux ◽  
Voice Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional

Objectives: This study aimed to assess potential associations between self-reported symptoms of laryngopharyngeal reflux (LPR) and voice disorders among two undiagnosed cohorts in Saudi Arabia. Methods: This cross-sectional study was conducted from February to April 2017 in Khobar, Saudi Arabia. Validated Arabic versions of the Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) were distributed to 400 teachers at 13 schools and 300 members of the general population attending an ear, nose and throat clinic in Khobar. Scores of >13 and >11 on the RSI and VHI-10 indicated a potential subjective diagnosis of LPR and voice disorders, respectively. Results: A total of 446 individuals took part in the study, including 260 members of the general population (response rate: 86.7%) and 186 teachers (response rate: 46.5%). The mean age was 32.5 years. In total, 62.2% complained of voice and/or reflux problems, with the remaining 37.8% not reporting/unaware of any problems in this regard. Among the teachers, 30.6% and 18.3% had positive RSI and VHI-10 scores, respectively, while 43.1% and 14.6% of the individuals from the general population had positive RSI and VHI-10 scores, respectively. Overall, VHI-10 scores were significantly associated with RSI scores (P <0.001). Conclusion: A significant association between RSI and VHI-10 scores suggests that there may be an association between LPR and voice disorders. These tools would therefore be a valuable method of monitoring patients; however, they cannot be used to confirm a diagnosis. Thus, more detailed studies are needed to confirm this association using a larger sample size.Keywords: Voice Disorders; Laryngopharyngeal Reflux; Hoarseness; Diagnostic Self Evaluation; School Teachers; Saudi Arabia.

scholarly journals Does laryngopharyngeal reflux affect voice quality? a cross-sectional study

2021 ◽  
Vol 7 (6) ◽  
pp. 1021
Author(s):  
Almas J. Vakil ◽  
Pratibha Vyas ◽  
Shreya Prasad ◽  
Praveen Singh
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Voice Quality ◽  
Voice Disorders ◽  
Empirical Therapy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Voice Change ◽  
Symptom Index ◽  
Cross Sectional

<p class="abstract"><strong>Background: </strong>Laryngopharyngeal reflux (LPR) is a rising disease that leads to voice changes. This study aimed to assess the potential association between the symptoms of laryngopharyngeal reflux (LPR) and voice disorders using the Reflux symptom index (RSI) and the Voice handicap index (VHI-10) scales, respectively.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was conducted in the Department of Otorhinolaryngology at Mahatma Gandhi Medical College and Hospital, Jaipur, India, from June 2019 to November 2019, on a sample size of 144 patients having complaints related to voice change and laryngopharyngeal reflux. The participants filled the RSI and the VHI-10 questionnaires. RSI scores of &gt;13 and VHI-10 scores of &gt;11 indicated LPR-related symptoms and voice disorders, respectively.</p><p class="abstract">Results: The study included 70 (48.61%) patients who were males and 74 (51.38%) patients who were females. The mean age was 33.5 years. Overall, 89(61.80%) patients had RSI scores of &gt;13 while 102 (70.83%) patients had VHI-10 scores of &gt;11. A significant association was found between positive RSI and VHI-10 scores (p&lt;0.001).</p><p class="abstract"><strong>Conclusions: </strong>A significant association between RSI and VHI-10 scores reflects an association of laryngopharyngeal reflux with long-standing voice change. RSI and VHI-10 may constitute valuable tools in diagnosing suspected patients with voice change and direct early start of empirical therapy with PPI.</p>

scholarly journals Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Ayham Ghareeb
Keyword(s):  
Allergic Rhinitis ◽  
Reflux Disease ◽  
Medical Condition ◽  
Laryngopharyngeal Reflux ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional ◽  
Wide Range

AbstractAllergic rhinitis (AR) is a common medical condition worldwide. It is an inflammation in the nasal mucosa due to allergen exposure throughout the year. Laryngopharyngeal reflux (LPR) is another medical condition that can overlap with AR. LPR can be considered an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity. Its diagnosis imposes a real challenge as it has a wide range of unspecific symptoms. Although AR and LPR are not life-threatening, they can severely affect the quality of life for years and cause substantial distress. Moreover, having AR is associated with having asthma which is also in turn associated with GORD. This is a cross-sectional study which used surveys distributed online on Social Media and targeted people across Syria. All participants who responded to the key questions were included. Reflux symptom index (RSI) was used for LPR, and score for allergic rhinitis (SFAR) was used for AR. Demographic questions and whether the participant had asthma were also included in the survey. We found that there was an association between the symptoms of LPR and AR p < 0.0001 (OR, 2.592; 95% CI 1.846–3.639), and their scores were significantly correlated (r = 0.334). Having asthma was associated with LPR symptoms p = 0.0002 (OR 3.096; 95% CI 1.665–5.759) and AR p < 0.0001 (OR 6.772; 95% CI 2.823–16.248). We concluded that there was a significant association between having LPR, AR, and asthma. We need more studies to distinguish between their common symptoms and aetiologies.

A Randomized Clinical Trial of Proton Pump Inhibitors Combined with Traditional Chinese Medicine in the Treatment of Laryngopharyngeal Reflux Disease

2021 ◽  
Author(s):  
Feng Pei ◽  
Wei Jia Hu ◽  
Yi Nan Mao ◽  
Yu Liang Zhao
Keyword(s):  
Proton Pump ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Short Form ◽  
Therapeutic Effects ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Group A ◽  
Group B

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.

Usefulness of Matrix Metalloproteinase-7 in Saliva as a Diagnostic Biomarker for Laryngopharyngeal Reflux Disease.

2021 ◽  
Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek
Keyword(s):  
Matrix Metalloproteinase ◽  
Sensitivity And Specificity ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Diagnostic Methods ◽  
Reflux Symptom Index ◽  
Enzyme Activity Assay ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Matrix Metalloproteinase 7

Abstract Introduction Several diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Objectives Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. Method We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. Results There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. Conclusion An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.

Shar Pei Larynx: Supraglottic and Postcricoid Mucosal Redundancy and Its Association With Medical Comorbidities

2018 ◽  
Vol 128 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Yin Yiu ◽  
Kathleen M. Tibbetts ◽  
C. Blake Simpson ◽  
Laura A. Matrka
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Future Research ◽  
Morbidly Obese ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Obstructive Sleep

Objectives: The aim of this study is to describe a clinical entity the authors term “Shar Pei larynx,” characterized by redundant supraglottic and postcricoid mucosa that the authors hypothesize coexists in patients with obstructive sleep apnea, laryngopharyngeal reflux, and obesity. By exploring this hypothesis, the authors hope to set the foundation for future research with the goal of identifying whether Shar Pei larynx is a marker for untreated sleep apnea or other diseases. Study Design: Retrospective chart review. Setting: Two tertiary care academic institutions. Methods: Data were collected from a 5-year period by querying for patients described to have “Shar Pei larynx” or “posterior supraglottic and/or postcricoid mucosal redundancy” on laryngoscopic findings. Relevant demographic and clinical characteristics were analyzed, with a focus on associations with obesity, sleep apnea, and laryngopharyngeal reflux. Results: Thirty-two patients were identified with physical findings consistent with Shar Pei larynx. Twenty-six patients (81.3%) were obese; 16 (50%) were morbidly obese. Twenty-two patients (68.8%) either had an existing diagnosis of obstructive sleep apnea or were diagnosed on polysomnography performed after initial evaluation. Sixteen patients (50%) had type 2 diabetes mellitus, and 87.5% of these patients were obese. Twenty-eight patients (87.5%) noted histories of reflux, with a median reflux symptom index of 27 of 45. Five patients underwent procedures to reduce mucosal redundancy related to Shar Pei larynx. Conclusions: This pilot study confirms that the majority of patients diagnosed with Shar Pei larynx also had diagnoses of obesity, obstructive sleep apnea, and reflux disease. The demonstrated association is strong enough to warrant further study.

scholarly journals Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints?

2017 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Rajesh Vishwakarma ◽  
Ruta V Shah
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Female Ratio ◽  
The Real ◽  
Body Sensation ◽  
Male Female Ratio ◽  
The Mean ◽  
Nose And Throat

ABSTRACT Aim The aim of this study is to evaluate the role of laryngopharyngeal reflux (LPR) in patients with laryngeal complaints and study the correlation between reflux symptom index (RSI) and reflux finding score (RFS). Materials and methods This is a study of 104 patients, who presented in the ear, nose, and throat outpatient department at the Civil Hospital, Ahmedabad, India, from April 2015 to April 2016, with complaints like change of voice, chronic cough, foreign body sensation, throat clearing, difficulty swallowing, and regurgitation. All the patients were examined with 90° endoscope by a single examiner, and an RSI ≥13 was considered as indicative of reflux. Observation and discussion The mean age of the 104 patients was 47.2 years. The male-female ratio was 1:1.8. The RSI ranged from 5 to 44, with a mean of 22.99 and standard deviation (SD) of 7.43. The RFS ranged from 4 to 22, with a mean of 11.04 and SD of 3.07. Both the parameters showed high correlation (correlation coefficient 0.98). Conclusion The LPR plays an important contributory role in patients with laryngeal complaints. The RFS and RSI can be used as routine parameters in establishing the diagnosis of reflux. How to cite this article Shah RV, Vishwakarma R. Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints? Int J Phonosurg Laryngol 2017; 7(1):6-9.

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