Correlation of Clinical Symptoms and Laryngoscopic Signs in Reflux Laryngitis” -A One year Cross-Sectional study in a Tertiary Care Center, KLES Dr. Prabhakar Kore Hospital, Belagavi

Abstract

Background: The proximity of the larynx and proximal esophagus makes it susceptible to diseases that occur in these 2 areas, due to gastro-esophageal reflux disease (GERD). Unfortunately, there is a substantial percentage of medical professionals that are unaware of this. Patients with laryngopharyngeal reflux usually come to the ENT OPD with complains of hoarseness and Globus. The advent of fibreoptic flexible endoscopes has changed the scenario for diagnosis. The Reflux Symptom Index is used for clinical diagnosis and the Reflux Finding Score is used to assess the Laryngoscopic findings. Objective: To assess the Correlation between the Clinical Symptoms and Laryngoscopic findings of Reflux Laryngitis using the Reflux Symptoms Index (RSI) and the Reflux Finding Score (RFS). Materials & Methods: This is a cross-sectional study conducted in the department of Otorhinolaryngology of Dr. Prabhakar Kore Hospital, Belagavi, from January 2018 to December 2018. 75 patients were included in the study, who came to the OPD with typical and atypical findings of GERD. Their symptoms were scored using the Reflux Symptom Index (RSI) and all patients with abnormal RSI (>13) were subjected to laryngoscopy and the findings were assessed using the Reflux Finding Score. Results: The study included 40 males and 35 females with mean age of patients being 40.96. The most common presenting complaint was heartburn, feeling of lump in the throat (Globus) and hoarseness. Among patients who underwent flexible fibreoptic laryngoscopic examination, 55 patients were found to have a significant score (RFS>7). The most common finding was erythema of laryngeal mucosa, posterior commissure hypertrophy, vocal fold edema and partial ventricular obliteration. On comparing the two scores, they showed a strong correlation (p Value =0.007). Conclusion: Laryngopharyngeal reflux / Reflux laryngitis being a diagnostic dilemma requires comprehensive evaluation of the symptoms first followed by laryngoscopic examination to assess the laryngeal changes. Our study concluded that RSI and RFS are easy, reproducible and complimentary scores that can be used to make a likely diagnosis of LPR.