Objectives/Hypothesis To develop and validate the Reflux Symptom Score (RSS), a self‐administered patient‐reported outcome questionnaire for patients with laryngopharyngeal reflux (LPR). Study Design Prospective controlled study. Methods A total of 113 patients with LPR were enrolled and treated with diet and 3 months of pantoprazole, alginate, and/or magaldrate depending on the LPR characteristics (acid, nonacid, or mixed). Eighty asymptomatic individuals completed the study. Patients and controls completed the RSS twice within a 7‐day period to assess test‐retest reliability. Internal consistency was measured using Cronbach's α for the RSS items in patients and controls. Validity was assessed by comparing the baseline RSS with the Reflux Symptom Index (RSI) and Voice Handicap Index (VHI). Seventy‐seven patients completed the RSS at baseline and after 6 and 12 weeks of treatment to assess responsiveness to change. The RSS cutoff for determining the presence and absence of LPR was examined by receiver operating characteristic analysis. Results Test‐retest reliability (rs = 0.921) and internal consistency reliability (α = 0.969) were high. RSS exhibited high external validity indicated by a significant correlation with the RSI (rs = 0.831). Internal validity was excellent based on the higher RSS in patients compared with controls (P = .001). RSS, RSI, and VHI scores significantly improved from pre‐ to posttreatment, indicating a high responsiveness to change. RSS >13 can be considered suggestive of LPR‐related symptoms. RSS was not influenced by the occurrence of gastroesophageal reflux disease, LPR subtypes, or patient characteristics. Conclusions RSS is a self‐administered patient‐reported outcome questionnaire that demonstrates high reliability and excellent criterion‐based validity. RSS can be used in diagnosing and monitoring LPR disease. Level of Evidence 3b Laryngoscope, 130:E98–E107, 2020

Purpose To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. Methods Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the “Sniffin Sticks” test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. Results Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. Conclusion Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.

Objectives/Hypothesis To investigate the profile of patients with laryngopharyngeal reflux (LPR) at hypopharyngeal–esophageal multichannel intraluminal impedance‐pH (HEMII‐pH) monitoring and the relationship between hypopharyngeal‐proximal reflux episodes (HREs) and saliva pepsin concentration. Study Design Prospective non‐controlled. Methods Patients were recruited from three European hospitals from January 2018 to October 2019. Patients benefited from HEMII‐pH monitoring and saliva collections to measure saliva pepsin concentration in the same time. Saliva pepsin concentration was measured in the morning (fasting), after lunch, and after dinner. The LPR profile of patients was studied through a breakdown of the HEMII‐pH findings over the 24 hours of testing. The relationship between the concentrations of saliva pepsin and 24‐hour HREs was studied through linear multiple regression. Results One hundred twenty‐six patients completed the study. The HEMII‐pH analyses revealed that 73.99% of HREs occurred outside 1‐hour postmeal times, whereas 20.49% and 5.52% of HREs occurred during the 1‐hour postmeal and nighttime, respectively. Seventy‐four patients (58.73%) did not have nighttime HREs. Patients with both daytime and nighttime HREs had more severe HEMII‐pH parameters and reflux symptom score compared with patients with only daytime HREs. There were no significant associations between HREs and saliva pepsin concentration. Conclusions Unlike gastroesophageal reflux disease, HREs occur less frequently after meals and nighttime. The analysis of the HEMII‐pH profile of the LPR patients has to be considered to develop future personalized therapeutic strategies. Level of Evidence 4 Laryngoscope, 131:268–276, 2021

Objective To investigate the clinical features and the therapeutic response of laryngopharyngeal reflux (LPR) patients with or without gastroesophageal reflux disease (GERD). Methods Patients with LPR symptoms were enrolled from three European Hospitals. The diagnosis of LPR and GERD was made through impedance‐pH monitoring (MII‐pH). A gastrointestinal endoscopy was realized in patients with digestive complaints or ≥60 years old. The 3‐ to 6‐month treatment was based on the association of diet, pantoprazole, alginate, and magaldrate regarding the MII‐pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used to evaluate the clinical evolution throughout treatment. The gastrointestinal endoscopy findings, clinical features, and therapeutic response were compared between patients with LPR and GERD (LPR/GERD) and patients with LPR. Results One hundred and eleven LPR patients were included, 54 being LPR/GERD. LPR/GERD patients had a higher number of proximal reflux episodes compared with LPR patients. The prevalence of esophagitis, hernia hiatal, and lower esophageal sphincter insufficiency did not differ between groups. The presence of GERD was strongly associated with acid LPR. Patients without GERD had a higher proportion of nonacid and mixed LPR compared with LPR/GERD patients. The pre‐ to posttreatment evolutions of RSS and RSA were quite similar in both groups, with the exception of the 3‐ to 6‐month improvement of digestive symptoms, which was better in LPR/GERD group. The therapeutic success rates were 79.6% and 77.2% in GERD/LPR and LPR group, respectively. Conclusion GERD is predictive of acid LPR. The clinical evolution and the therapeutic response rates were quite similar in both groups. Level of Evidence 4 Laryngoscope, 130: E479–E489, 2020

No abstract