Laryngopharyngeal reflux highly High prevalent among patients experiencing persistent hoarseness of voice, reveals study

India: A recent study published in the Indian Journal of Otolaryngology and Head & Neck Surgery suggests considering laryngopharyngeal reflux disease (LPRD) in patients presenting with voice hoarseness for more than three weeks.

The study unveiled a notable association with gender (70.3% female), age (41–50 years), & severity of voice use, with hoarseness identified as the most prevalent symptom. The findings encourage using easily applicable Koufmann Reflux Symptom Index & Reflux Finding Scores in routine assessments.

Laryngopharyngeal reflux is the backflow of gastric contents into the laryngopharynx where it comes in contact with the tissues of the upper aerodigestive tract. It concerns 4 to 10 % of patients who seek Ear Nose Throat (ENT) consultation and 1 % of patients in primary care practice. The most common symptoms reported are throat clearing, globus sensation, and voice disorders such as hoarseness.

Kirubhagaran Ravichandran, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry, India, and colleagues aimed to evaluate the presence of laryngopharyngeal reflux in patients with voice disorders thereby aiding in the early management and improving the quality of life.

For this purpose, the researchers conducted a cross-sectional study at a tertiary care hospital, including patients with a history of voice change for more than three weeks. The patients were divided into four groups based on the level of voice use.

Patients were asked to fill Koufmann Reflux Symptom Index questionnaire followed by a video laryngoscopy. The findings were plotted according to the Reflux Finding Score. The impact of LPRD in patients with voice disorders was analysed based on the scoring.

The key findings of the study were as follows:

· Among the 90 study participants, 82.2% were found to have LPRD. The mean age was 42.76 ± 10.33 years.

· Majority (43.2%) belong to the age group of 41–50 years, with female predominance (70.3%).

· Majority (41.9%) of them were level IV voice users.

· 59.5% were positive Koufman reflex symptom index, and 67.6% were positive Reflex finding score.

· Hoarseness (58.1%) was the most common symptom.

The findings have brought to light a high prevalence of laryngopharyngeal reflux disease in patients experiencing persistent voice disorders.

“Simple and highly reproducible scores like Reflux Finding Score and Reflux Symptom Index have proven useful and valuable tools in LPRD diagnosis, thereby aiding in early diagnosis and prompt management and improving the patient’s quality of life,” the researchers wrote.

Reference:

Padmanabhan, K., Ravichandran, K. & Sivanand, N. Impact of Laryngopharyngeal Reflux in Patients with Voice Disorders. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04541-x

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