ORIGINALS
IMAJ | volume 26
Journal 1, January 2024
pages: 40-44
Incidental Laryngeal Findings in Routine Laryngopharyngeal Reflux Diagnosis
- Forsan Jahshan,
- Tal Marshak ,
- Jamal Qarawany ,
- Boaz Markel ,
- Amiel Sberro,
- Yonatan Lahav ,
- Eli Layous ,
- Netanel Eisenbach ,
- Isaac Shochat,
- Eyal Sela ,
- Ohad Ronen
1 Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2 Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
3 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
4 Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
5 Department of Otolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel
6 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
7 Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
8 Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Summary
Background:
Laryngopharyngeal reflux (LPR) refers to the backflow of acidic stomach content into the larynx, pharynx, and upper aerodigestive tract. The diagnosis of LPR is based on the patient's history and findings of the laryngoscopy associated with LPR. Other possible manifestations consistent with LPR symptoms include laryngeal cancer, vocal fold granulomas, Reinke's space edema, and vocal polyps. In this study, we compared the characteristics of patients with LPR symptoms and incidental laryngeal findings (ILF) in the laryngoscopic evaluation to those without ILF (WILF).
Objectives:
Determine the characteristics of LPR-symptomatic patients with ILF versus WILF.
Methods:
In this retrospective study, we examined 160 medical charts from patients referred to the otolaryngology clinic at Galilee Medical Center for LPR evaluation 2016–2018. The reflux symptoms index (RSI), reflux finding score (RFS), and demographics of the patient were collected. All patients with a positive RSI score for LPR (RSI > 9) were included, and the profiles of patients with versus without ILF on laryngoscopy examination were compared.
Results:
Of the 160 patients, 20 (12.5%) had ILF during laryngoscopy. Most had vocal cord findings such as leukoplakia (20%), polyps (15%), and nodules (20%). Hoarseness, throat clearing, swallowing difficulty, breathing difficulties, and total RSI score were significantly higher in patients with ILF.
Conclusions:
Evaluation of LPR symptoms may provide otolaryngologists with a tool to identify patients with other findings on fiberoptic laryngoscopy. A laryngoscopic examination should be part of the examination of every patient with LPR to enable diagnosis of incidental findings.