gms | German Medical Science

Introduction: Extraesophageal reflux (EER, laryngopharyngeal reflux) is the retrograde movement of the gastric content into the larynx, pharynx and upper aerodigestive tract. The Reflux Finding Score (RFS) was developed to standardize the laryngeal findings of EER so that clinicians may better evaluate the severity of EER and assess clinical improvement of the laryngeal signs after therapy.

Methods: The RFS was evaluated in 37 patients (age between 18 and 70 years) with suspected EER. Thereafter, double-probe pH monitoring was performed. Patients with Reflux area index 4 higher then 6.3 were considered to have clear pathological EER. After the therapeutic trial with proton pump inhibitor (lansoprazol 30mg twice daily for 12 weeks) the RFS was evaluated again.

Results: 31 of 37 patients completed the study and were used for further statistical analysis. The mean RFS before treatment was 7.7. In the group of 11 patients with clear EER (pH monitoring), the mean RFS was 8.9 (group I), in the group of 20 patients without clear pathological EER, the mean RFS was 7.0 (group II). The most frequent findings in the both groups were erythema (89%), vocal cord edema (68%) and ventricular obliteration (41%). After the treatment the mean RFS improved significantly in group I (from 8.9 to 6.6) and in the group II as well (from 7 to 5.9). The improvement was most frequently noticed in glottic oedema and erythema.

Conclusions: According to our study, symptoms of EER improve significantly after 12 weeks proton pump inhibitor trial. The improvement was significantly higher in the group with clear pathological EER confirmed by pH monitoring. The RFS can by used for the documentation of treatment efficacy in patients with EER.

This study was supported by Grant IGA MZ CR 10612-3.