Comparison of Basic Diagnostic Methods (Reflux SymptomIndex, Reflux Finding Score, Therapeutic Trial, pH-metry)
Authors:
Karol Zeleník
; H. Kopřivová; Pavel Komínek
Authors‘ workplace:
Otorinolaryngologická klinika FN Ostrava
přednosta doc. MUDr. P. Komínek, Ph. D., MBA
Published in:
Otorinolaryngol Foniatr, 60, 2011, No. 2, pp. 71-77.
Category:
Original Article
Overview
Objective:
The aim of the study is to compare the importance of basic methods used in the diagnosis of extraesophageal reflux (EER) - Reflux symptom index (RSI), Reflux finding score (RFS), therapeutic trial (TT) and pH-monitoring.
Methods:
Patients with typical symptoms of the EER (especially hoarseness, throat cleaning, coughing and globus pharyngeus) lasting at least three months and/or symptoms of reflux laryngitis were included in the study. Demographic data, RSI and RFS were recorded. Subsequently, pH-metry was performed and patients were put on proton pump inhibitor trial for 12 weeks.
Results:
Pathological EER was detected in 24.9% of patients coming to the ENT clinic with symptoms of EER. The other 38.3% of patients had episodes of EER, but these were not severe enough to meet criteria for pathological EER. The mean RSI of patients with pathological EER was 21.86, in patients without EER according to pH-monitoring was 17.68. The difference was not statistically significant. The mean RFS in patients with pathological EER was 8.57, in patients without EER according to pH-monitoring was 6.16. The difference was statistically significant. Between the RSI and RFS was found only a very weak positive correlation. Patients with positive TT had significantly higher values of RSI, and had significantly more often pathological EER demonstrated with pH-monitoring.
Conclusions:
Pathological EER was demonstrated in a quarter of patients coming to the ENT clinic with clinical symptoms of EER. Pathological diagnosis of EER is very likely if the RSI is greater than 20 and/or the RFS is higher than 7. TT was confirmed to be a useful diagnostic instrument; however pH-monitoring is the most accurate diagnostic method for detection of EER.
Keywords:
extraesophageal reflux, pH-monitoring, Reflux symptom index, Reflux finding score, therapeutic trial.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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