Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux. (9th December 2013)

• Record Type: Journal Article
• Authors: Rafii, Benjamin; Taliercio, Salvatore; Achlatis, Stratos; Ruiz, Ryan; Amin, Milan R.; Branski, Ryan C.
• Is Part Of: Laryngoscope. Volume 124:Number 6(2014:Jun.)
• Page Start: 1420
• Page End: 1424
• Publication Date: 2013-12-09
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24483
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24483-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To characterize the videoendoscopic laryngeal findings in patients with a prior established diagnosis of laryngopharyngeal reflux disease (LPR) as the sole etiology for their chief complaint of hoarseness. We hypothesized that many, if not all, of these patients would present with discrete laryngeal pathology, divergent from LPR.</p> </sec> <sec id="lary24483-sec-0002" sec-type="section"> <title>Study Design</title> <p>Prospective, nonintervention.</p> </sec> <sec id="lary24483-sec-0003" sec-type="section"> <title>Methods</title> <p>Patients presenting to a tertiary laryngology practice with an established diagnosis of LPR as the sole etiology of their hoarseness were included. All subjects completed the Voice Handicap Index and Reflux Symptom Index, in addition to a questionnaire regarding their reflux diagnosis and prior treatment. Laryngoscopic examinations were reviewed by the laryngologist caring for the patients. Reliability of findings was assessed by interpretation of videoendoscopic findings by three outside laryngologists not involved in the care of the patients.</p> </sec> <sec id="lary24483-sec-0004" sec-type="section"> <title>Results</title> <p>Laryngeal pathology distinct from LPR was identified in all 21 patients felt to be causative of the chief complaint of dysphonia. Specifically, the most common findings were benign mucosal lesions and vocal fold paresis (29% each), followed by muscle tension dysphonia (14%). Two patients were found to have vocal fold leukoplakia, of which one was confirmed to be a microinvasive carcinoma upon removal.</p> </sec> <sec id="lary24483-sec-0005" sec-type="section"> <title>Conclusion</title> <p>LPR may be overdiagnosed; other etiologies must be considered for patients with hoarseness who fail empiric LPR treatment.</p> </sec> <sec id="lary24483-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4. <italic>Laryngoscope</italic>, 124:1420–1424, 2014</p> </sec> </abstract>