Laryngopharyngeal reflux (LPR) is gaining extensive attention in recent years because of the high incidence. But because of the complex symptoms and signs, there exist no diagnostic consensus. In this paper, the available objective diagnostic methods so far are reviewed, in the purpose of discussing the approach of objective and accurate diagnosis of LPR.
Humans ; Laryngopharyngeal Reflux ; diagnosis

At present, objective methods for diagnosing laryngopharyngeal reflux disease(LPRD) are not minimally invasive, effective, and economical. Diagnostic scales are widely used worldwide due to the advantages of inexpensive, noninvasive, and easy to operate. The reflux symptom index(RSI) and the reflux finding score(RFS) are preferred to use in clinical diagnosis. However, many controversies have appeared in the application of RSI and RFS in recent years, causing many troubles to clinical diagnosis. Therefore, this review briefly discusses the problems of RSI and RFS in clinical applications to provide reference for diagnosing LPRD accurately.
Humans ; Laryngopharyngeal Reflux/diagnosis*

Humans ; Laryngopharyngeal Reflux ; diagnosis ; therapy

Humans ; Laryngopharyngeal Reflux ; diagnosis ; therapy

Consensus ; Humans ; Laryngopharyngeal Reflux ; diagnosis ; therapy

Humans ; Hypopharynx ; Laryngopharyngeal Reflux/diagnosis* ; Respiratory System

PURPOSE: There are many articles about the role of barium esophagography for the diagnosis of gastroesophageal reflux disease. However, there are only rare articles reporting on laryngopharyngeal reflux disease. The purpose of this study is to evaluate the usefulness of performing esophagography with the water-siphon test as an initial screening test for patients with suspected laryngopharyngeal reflux. MATERIALS AND METHODS: From October 2002 to December 2004, barium esophagography with the water-siphon test was performed for 707 patients who had the typical symptoms and telescopic findings of laryngopharyngeal reflux. The results of the 707 esophagograms (the group with laryngopharyngeal reflux) were compared with those of 122 patients who were confirmed as having gastroesophageal reflux upon performing pH-metry (the group with gastroesophageal reflux) and the 324 patients without laryngopharyngeal reflux symptoms (the control group). The results of the water-siphon test were classified into normal, mild, moderate and severe degrees of gastroesophageal reflux. RESULTS: On the water-siphon test for the laryngopharyneal reflux group patients, 71 patients had normal (10.0%), 207 had mild (29.2%), 201 had moderate (28.4%) and 228 had severe (32.2%) degrees of reflux. The positive rates of the water-siphon test were 90.0%, 89.3% and 54.6% for the groups with laryngopharyngeal reflux, gastroesophageal reflux and the control group, respectively. A statistically significant difference was observed between the group with laryngopharyngeal reflux and the control group, and between the group with gastroesophageal reflux and the control group, respectively (p>0.05). CONCLUSION: Esophagography with the water-siphon test is useful as an initial screening test for laryngopharyngeal reflux disease.
Barium ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Laryngopharyngeal Reflux* ; Mass Screening*

BACKGROUND/AIMS: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease. Endoscopic assessment of LPR is needed for convenient diagnosis and documentation of treatment efficacy. The aim of this study was to investigate the interrater reliability of LPR among endoscopists based on endoscopic laryngeal images. MATERIALS AND METHODS: Nineteen endoscopists participated in this study. Before the test, they completed an intensive education program by an otorhinolaryngologist on the reflux finding score (RFS), which is a validated laryngoscopic assessment of LPR. A total of 100 endoscopic laryngeal images were used for 3 tests of RFS. Cohen's and Fleiss' kappa coefficients were used to determine the degree of interrater agreement in the diagnosis of LPR. RESULTS: In the first test, the mean of Cohen's kappa coefficients for LPR diagnosis between the otorhinolaryngologist and each of the 19 endoscopists was 0.3. In the second test, after additional education, the mean kappa value was 0.32. Fleiss' kappa coefficients for diagnosis of LPR among the 19 endoscopists in the first and second tests were 0.30 and 0.26, respectively. CONCLUSIONS: A short-term education program for endoscopists did not result in an improvement of accuracy in the diagnosis of LPR. Further studies using advanced educational programs for endoscopists are required.
Diagnosis* ; Education ; Endoscopy* ; Gastroesophageal Reflux ; Laryngopharyngeal Reflux* ; Treatment Outcome

BACKGROUND AND OBJECTIVES: A 24-hour ambulatory dual probe for pH monitoring is the most specific and sensitive test for laryngopharyngeal reflux (LPR) disease. However, the use of this probe is not well tolerated in some patients due to discomfort and the invasive nature of the procedure. Thus, the diagnosis of LPR is usually made according to symptomatic responses to empirical treatment using a proton-pump inhibitor for patients with high score of reflux symptom index (RSI) and reflux finding score (RFS). The aim of this study is to evaluate the relationship between the RSI and RFS and pH monitoring using a 24-hour ambulatory dual probe, and determine the role of RSI and RFS in the diagnosis of LPR. SUBJECTS AND METHOD: We studied 100 patients who underwent pH monitoring using a 24-hour dual probe because of laryngopharyngeal reflux related symptoms or laryngoscopic findings. The various parameters of the 24-hour dual probe pH monitoring were compared with the scores of RSI and RFS. RESULTS: In 24-hour dual probe pH monitoring, 64 of 100 patients tested positive for LPR. The mean of RSI score was significantly higher in the positive LPR group than in the negative group. However, RFS did not differ between the two groups. RSI scores were significantly associated with the reflux number in the upright position of the 24-hour dual probe pH monitoring. There was no correlation between RFS and the parameters of the 24-hour dual probe pH monitoring. CONCLUSION: RSI can be a reliable diagnostic tool for laryngopharyngeal reflux disease instead of the 24-hour ambulatory dual probe pH monitoring.
Diagnosis ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration* ; Laryngopharyngeal Reflux*

Objective: To investigate the daily variation of LPR and the significance of 48-hour oropharyngeal pH monitoring in the diagnosis of LPRD. Methods: 72 subjects with suspected LPRD who were treated in our department from June 2018 to June 2021 were included. All patients were hospitalized to complete continuous 48-hour oropharyngeal Dx-pH monitoring. The consistency of Ryan index and W index and the correlation of various reflux parameters between the first and second 24-hour were compared. SPSS 24.0 was used for statistical analysis. Results: All 72 subjects successfully completed 48-hour oropharyngeal Dx-pH monitoring. Ryan index was positive in 11 cases (15.2%) in the first 24-hour, in 17 cases (23.6%) in the second 24-hour, in 5 cases (6.9%) both first and second, and in 23 cases (31.9%) in either 24-hour, Kappa=0.211 (P=0.064), 18 cases (25%) had inconsistent results of the first 24-hour and the second 24-hour, and there was no significant difference in the positive rate between the first and second (P=0.234). The number of positive cases in 48-hour monitoring increased by 109.1% compared with 24-hour monitoring.For W index, 49 cases (68.1%) were positive in the first 24-hourf 53 cases (73.6%) were positive in the second 24-hour, 42 cases (58.3%) were positive both first and second, and 58 cases (80.6%) were positive in either 24-hour, Kappa=0.477 (P<0.001), 16 cases (22.2%) had inconsistent results of the first and second, and there was no significant difference in the positive rate between the first and second (P=0.804). The number of positive cases in 48-hour monitoring increased by 18.4% compared with 24-hour monitoring. There was no significant difference in all the reflux parameters of first and second (P>0.05). The correlation comparison showed that the correlation of various reflux parameters in the upright position was lower than that in the supine position. Conclusion: Laryngeal reflux has daily variability. Extending the monitoring time of Dx-pH to 48-hour can help reduce the missed diagnosis caused by daily variability; the use of W index can reduce the influence of daily variability on the diagnostic results of LPRD.
Humans ; Laryngopharyngeal Reflux/diagnosis* ; Hydrogen-Ion Concentration ; Hypopharynx ; Larynx