ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

by John Austin • August 1, 2006

  • Tweet
  • Email
Print-Friendly Version

CHICAGO-Laryngopharyngeal reflux (LPR) is considered one of the most complex and difficult-to-diagnose manifestations of gastroesophageal reflux disease (GERD). Although it has been estimated that LPR is present in up to 50% of patients with voice disorders, there have been no validated instruments for quantifying the physical symptoms and severity of LPR.

You Might Also Like

  • Laryngopharyngeal Reflux Gaining Recognition as Distinct Disorder, Paving the Way for Research and Treatment
  • Voice Therapy Improves Reflux Symptoms in Patients with Voice Complaints
  • Some Laryngopharyngeal Reflux Resists PPI Treatment
  • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
Explore This Issue
August 2006

Much effort has been spent over the past few years in developing such instruments, said Tamer A. Mesallam, MD, MSc, of the Cincinnati Children’s Hospital Medical Center (Ohio). Two instruments-Reflux Finding Score (RFS) and Reflux Symptom Index (RSI)-are commonly used as assessment tools in diagnosing and treating LPR.

Dr. Mesallam presented a paper comparing these two measurement tools at a session hosted by the American Broncho-Esophageal Association (ABEA) here at the Combined Otolaryngology Spring Meetings (COSM).

Quantifying LPR

Table. Reflux Finding Score

click for large version
Table. Reflux Finding Score

The most commonly recognized signs and symptoms of LPR include hoarseness, vocal fatigue, excessive throat clearing, globus pharyngeus, chronic cough, postnasal drip, and dysphagia. Treatment options available to LPR patients include diet and behavior modification, antacids, H2-receptor antagonists, proton-pump inhibitors, and fundoplication surgery. Determining the appropriateness of these potential therapies, however, is dependent on the physician’s ability to accurately quantify the associated treatment outcomes.

RFS is an eight-item index designed to assess clinical severity based on laryngoscopic findings. Scores range from 0 (normal) to 26 (most severe), with a score of 11 or above generally considered to be indicative of LPR. The eight items included in the scale are subglottic edema, ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and excessive endolaryngeal mucus (see Reflux Finding Score, left).

The RSI is a nine-item self-administered outcome questionnaire designed to document LPR symptoms and severity. Patients are asked to rate how nine problems have affected them over the past month on a scale of 0 (no problem) to 5 (severe problem), with a maximum total score of 45. A total score of more than 13 is considered positive as far as diagnosis of LPR (see Reflux Symptom Index, above).

Table. Reflux Symptom Index

click for large version
Table. Reflux Symptom Index

While both RFS and RSI have been shown to be effective, the correlation between these two instruments has not been much studied, said Dr. Mesallam. The objective of our study was to determine the relation between RSI and RFS regarding total score.

Study Protocols

Forty randomly selected patients-14 males and 26 females between the ages of 17 and 60-were included in the study. A retrospective chart review was performed for those patients fitting the inclusion criteria to choose those with RSI suggestive of LPR. For RFS, the video stroboscopic samples for the study group were reviewed and rated by six experienced raters on two different occasions to evaluate inter- and intra-rater reliability. The RSI and RFS were statistically compared with regard to both the total scores and the individual parameters.

Pages: 1 2 | Single Page

Filed Under: Departments, Laryngology, Medical Education, Practice Focus Tagged With: COSM, diagnosis, outcomes, reflux, research, treatmentIssue: August 2006

You Might Also Like:

  • Laryngopharyngeal Reflux Gaining Recognition as Distinct Disorder, Paving the Way for Research and Treatment
  • Voice Therapy Improves Reflux Symptoms in Patients with Voice Complaints
  • Some Laryngopharyngeal Reflux Resists PPI Treatment
  • Experts Delve into Treatment Options for Laryngopharyngeal Reflux

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Otolaryngologists Have a Major Role to Play in Treating COVID-19 Long-Haulers
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.