| Title | Prevalence of laryngeal irritation signs associated with reflux in asymptomatic volunteers: impact of endoscopic technique (rigid vs. flexible laryngoscope). | | Author(s) | Milstein CF, Charbel S, Hicks DM, Abelson TI, Richter JE, Vaezi MF | | Institution | The Voice Center, Head and Neck Institute, Center for Swallowing and Esophageal Disorders, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. milstec@ccf.org | | Source | Laryngoscope 2005 Dec; 115(12):2256-61. | | MeSH | Adult
Comparative Study
Equipment Design
Female
Follow-Up Studies
Gastroesophageal Reflux
Humans
Laryngitis
Laryngoscopes
Laryngoscopy
Male
Observer Variation
Prevalence
Prognosis
Prospective Studies
Questionnaires
Research Support, N.I.H., Extramural
Risk Factors
Severity of Illness Index
Video Recording
| | Abstract | OBJECTIVES: The objectives of this study were to 1) determine the prevalence of ENT findings in the normal asymptomatic population and 2) to compare findings between flexible and rigid laryngoscopes in an attempt to increase specificity of diagnosis of reflux in endoscopic laryngeal examinations.
STUDY DESIGN: Prospective study.
METHODS: Fifty-two nonsmoker volunteers (24 male, 28 female), mean age of 42.7 years, with no history of ENT abnormalities or gastroesophageal reflux disease, underwent both rigid and flexible videolaryngologic examinations with a digital endoscopic unit. A group of three expert judges reviewed the oral and transnasal examinations blindly and independently for physical signs of irritation/inflammation commonly associated with reflux.
RESULTS: Atleast one sign of tissue irritation was detected in 93% and 83% of the population when using a flexible and a rigid laryngoscope, respectively. Results showed a high incidence of posterior commissure bar (53.2% and 51.9%), arytenoid complex edema/erythema (76.3% and 53.2%), and pseudosulcus (37.2% and 7.7%). Most signs were more frequently detected on flexible transasal examinations than with rigid transoral examinations: posterior pharyngeal wall (<0.01), interarytenoid irritation (<0.01), arytenoids complex irritation (<0.01), ventricular obliteration (<0.01), and pseudosulcus (<0.01).
CONCLUSIONS: Several signs of posterior laryngeal irritation (e.g., interarytenoid bar, erythema of the medial wall of the arytenoids), which are generally considered to be signs of laryngopharyngeal reflux, are present in a high percentage of nonsymptomatic individuals, raising question about their diagnostic specificity. In addition, these signs were more often detected with flexible than with rigid laryngoscopes, suggesting that flexible laryngoscopy is more sensitive but less specific in identifying laryngeal tissue irritation. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 16369176 |
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