Posterior Commissure Hypertrophy as Diagnostic and Prognostic Indicator for Laryngopharyngeal Reflux
ABSTRACT Purpose To establish posterior commissure hypertrophy as tool to diagnose laryngopharyngeal reflux (LPR) and to determine whether it can be used as a reliable marker for response to treatment. Materials and methods A prospective study of 100 patients with voice disorder was conducted. Patients were evaluated using reflux symptom index (RSI) and reflux finding score (RFS) by 70° Hopkins’ rigid laryngoscope. Those patients in whom RFS score was 7 or more were diagnosed to have LPR. These patients were then started on antireflux therapy along with lifestyle modification and were evaluated regularly over a period of 6 months. Results The prevalence of LPR in patients with voice disorders was found to be 25%. Mean age was 41.48 years and the male and female ratio was 0.85:1. Posterior commissure hypertrophy was present in 60 out of 100 patients (60%). Among laryngopharyngeal reflux disease (LPRD), 23 out of 25 patients (92%) had posterior commissure hypertrophy, out of which only 2 (8.6%) patients showed complete resolution of posterior commissure hypertrophy after 6 months of treatment. A total of 10 patients (43.47%) did not show any change in grading of posterior commissure hypertrophy. And 11 patients (47.82%) showed downgrading of posterior commissure hypertrophy. Sensitivity of posterior commissure hypertrophy for diagnosis of LPR was found to be 92%, whereas specificity was 50.66%. Conclusion Posterior commissure hypertrophy can be used as a screening tool for diagnosis of LPR but cannot be used reliably as a clinical marker for response to therapy. How to cite this article Joshi AA, Chiplunkar BG, Bradoo RA, Shah KD. Posterior Commissure Hypertrophy as Diagnostic and Prognostic Indicator for Laryngopharyngeal Reflux. Int J Phonosurg Laryngol 2015;5(2):57-60.