Mucosal changes in laryngopharyngeal reflux--prevalence, sensitivity, specificity and assessment

Area of Science:

• Otolaryngology
• Gastroenterology
• Medical Diagnostics

Background:

• Laryngopharyngeal reflux (LPR) diagnosis often relies on subjective assessment of mucosal signs in the larynx and pharynx.
• The prevalence and diagnostic accuracy of these signs, particularly in differentiating LPR from other conditions, require further investigation.

Purpose of the Study:

• To conduct a literature review on the utility of laryngopharyngeal mucosal signs for diagnosing LPR.
• To evaluate the existing evidence regarding the association between specific mucosal findings and confirmed LPR.

Main Methods:

• A comprehensive literature search was performed using MEDLINE in February 2012.
• Keywords included "laryngopharyngeal reflux," "laryngitis," "mucosa," "appearances," and "signs."
• Only English-language studies were included.

Main Results:

• Laryngopharyngeal mucosal signs associated with LPR were found in a significant percentage of both healthy volunteers (64%-93%) and individuals with gastroesophageal reflux disease (17%-85%).
• Certain signs like Reinke's edema and pseudosulcus showed higher prevalence in symptomatic LPR patients, but evidence varied across studies.
• The Reflux Finding Score (RFS) demonstrated high sensitivity (87.8%) but low specificity (37.5%) for identifying pH-proven pharyngeal reflux.

Conclusions:

• The diagnostic value of individual mucosal findings for LPR is limited, necessitating cautious interpretation.
• High-quality research is essential to establish reliable diagnostic criteria for LPR based on mucosal signs.