Symptoms, Quality of Life, Videolaryngoscopy, and Twenty-Four-Hour Triple-Probe Ph Monitoring in Patients with Typical and Extraesophageal Reflux

Abstract

A prospective study was designed to characterize patients with typical and extraesophageal reflux (EER) symptoms and seek predictive patterns for each group. Fifteen subjects without symptoms, 16 patients with symptomatic gastroesophageal reflux disease (GERD), and 37 patients with symptomatic EER were evaluated with outcomes tools, videolaryngoscopy, and 24-hour triple-probe pH monitoring. Higher symptom scores, Voice Handicap Index scores, and Gastrointestinal Symptom Rating Scale scores, as well as similarly decreased quality of life as measured by the Short Form 36, were noted among the two symptomatic groups. Patients with clinically diagnosed EER were more likely to have multiple abnormalities on laryngoscopy. There was a trend toward more pharyngeal reflux episodes in EER patients (6.9 +/- 8.9) as compared to GERD patients (6.0 +/- 9) and asymptomatic subjects (1.1 +/- 1.9). On the basis of the pH monitoring of asymptomatic subjects, we define pathological pharyngeal reflux as more than 5 episodes in 24 hours. Pharyngeal acid exposure is more common in patients presumed to have EER, but some pharyngeal reflux does occur in asymptomatic subjects. Neither symptom scores nor videolaryngoscopic findings were predictive of pathological EER as indicated by pH monitoring.

Posterior laryngitis: a study of persisting symptoms and health-related quality of life

“…The scores in our study were in the same range as found in previous studies describing patients suffering from posterior laryngitis, and confirm that these patients have a reduced HRQOL [26][27][28]. The new finding in the present study is that the reduced scores apply to the female population and not to the male population.…”

Avaliação do Voice Handicap Index em pacientes com perda auditiva neurossensorial bilateral a partir de grau moderado

“…The median found in that study for the total VHI score was 30, not so far from the one found in the present paper (23.5 Other comparable groups found in the literature were of patients with gastroesophageal reflux disorder 19 (mean total score of 21) and patients with laryngopharyngeal reflux (29.4 and 23.1 for women and men, respectively) 21 . The total scores of patients with laryngopharyngeal reflux were 28.14 in a study led by Pribuisiene et al in 2006 20 .…”

“…VHI was used as a means to measure the voicerelated handicap in different disease groups, such as organic dysphonias 15 , presbyphonia 16 , professional use of one's voice 17,18 , gastroesophageal reflux disorder (GERD) and laryngopharyngeal reflux disorders 19,20,21 , adduction and abduction spasmodic dysphonia 22,23,24 , thyroplasties 25,26,27 , microsurgery for benign 28,29 and malignant 30,31,32 disorders, radiography for laryngeal cancer 33 , use of tracheoesophageal 34 and speech therapy 35,36 . Numerous authors compared other methods of vocal assessment.…”

Diagnostic and management problems of laryngopharyngeal reflux disease in children

“…However, other investigators failed to confirm a relation between reported symptoms and pH probe diagnosed LPR [52] and its use in children has not been validated.…”

“…In this study, edema and erythema of the posterior supraglottis, vocal folds or subglottis were the most useful findings for diagnosis of reflux. Powitzky et al [52] in a prospective study developed a composite score based on six laryngeal findings (pseudosulcus, ventricular obliteration, posterior commissure thickening, granulomas, arytenoids erythema, vascularity) [52]. They found that composite scores, although higher in patients compared to the asymptomatic group, did not differ significantly between GERD and LPR patients and did not correlate with the number of pathologic hypopharyngeal reflux events.…”