Ann Clin Otolaryngol | Volume 9, Issue 1 | Research Article | Open Access
Filipa Morgado*, João Barbosa, Maria Machado, Alberto Santos and Carlos Macor
Hospital Beatriz Ângelo, Lisboa, Portugal
*Correspondance to: Filipa Morgado
Fulltext PDFIntroduction: Laryngopharyngeal Reflux (LPR) is a condition characterized by the retrograde flow of gastroduodenal contents into the upper aerodigestive tract, potentially leading to mucosal inflammation. Its diagnosis is often challenging due to the nonspecific nature of symptoms and findings. Clinical tools such as the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) can aid in diagnosis, but objective confirmation remains limited. pH-impedance monitoring has emerged as a complementary method, allowing detection of proximal reflux episodes regardless of acidity. Objectives: To evaluate and compare various diagnostic methods for LPR, namely through symptoms (RSI), Laryngoscopy Findings (RFS), and pH-impedance monitoring (PHI). Materials and Methods: A prospective study including patients with symptoms of Gastroesophageal Reflux (GER) who underwent pH-impedance monitoring in the last 6 months of 2023 was conducted. Patients completed the RSI and were evaluated for laryngoscopy findings using the RFS. Scores from RSI, RFS, and PHI parameters, such as number of reflux episodes (acidic and non-acidic), percentage of proximal reflux, and reflux index (RI), were compared. Results: Fifty-two patients, with a mean age of 64 years, were included. There were no statistically significant associations between RSI and RFS. Among patients with proximal reflux, the RSI-PHI analysis identified throat clearing as the most prominent symptom. There was a strong positive correlation between RFS and the number of acid reflux episodes (r = -0.754; p = 0.003). Additionally, the absence of pathological GER did not exclude the presence of LPR, as 22/30 patients, despite normal RI and DeMeester score, showed altered proximal reflux. Conclusion: Because RSI and RFS are inherently subjective, incorporating pH-impedance parameters may enhance diagnostic accuracy for LPR, particularly in patients with uncertain clinical findings.
Proximal Reflux; Ph Impedance; Gastroesophageal Reflux Disease (GERD); Ph Meter; Laryngopharyngeal Reflux Disease.
Morgado F, Barbosa J, Machado M, Santos A, Macor C. Comparison of Diagnostic Methods in Laryngopharyngeal Reflux: A
Prospective Study. Ann Clin Otolaryngol. 2025; 9(1): 1058.