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Specificity of the diagnostic materials for laryngopharyngeal reflux.

Rationale: Laryngopharygeal reflux (LPR) is a controversial area of diagnosis and
consequently management. Many patients suffering from voice and swallowing
disorders may be suffering from LPR but decreased specificity of diagnosis makes
management ineffective and impacts on quality of life as well as leading to overdiagnosis
of LPR.
Aims: (1) To establish the relationship between the Reflux Symptom Index (RSI) and
the Reflux Finding Score (RFS) in participants who have attended the Wits University
Donald Gordon Voice and Swallowing clinic. (2) To establish if there is a correlation
between the total RFS and RSI scores. (3) To ascertain which test items of the RSI
and the RFS are elevated in the participants. (4) To describe trends in RFS and RSI
sub scores and (5) to determine if extraneous factors such as age, gender, professional
voice use and smoking impact on the subscores of the RFS and RSI and to describe
the trends based on these variables
Method: A quantitative retrospective chart review of 105 patients who attended the
Voice and Swallowing clinic was conducted. Each participant completed a self-rating
scale for reflux severity (the RSI) as well as undergoing stroboscopic examination.
Stroboscopic results were rated by a multidisciplinary team (2 otolaryngologists, a
speech therapist and a voice coach) to ascertain the patient’s Reflux Finding Score
(RFS). Inferential and descriptive statistics were employed to achieve the aims.
Results: A weak negative significant correlation on totals of the RFS and RSI
(r=0,20; p= 0,0395) was established. There were a number of intra-item correlations
on the RSI and the RFS. Descriptive statistics revealed that hoarseness, excess mucus
and throat clearing were the most frequently rated symptoms on the RSI and
erythemia, posterior commisure hyperatrophy and diffuse laryngeal oedema most
frequently rated signs on the RFS. Gender was the only variable found to have a
significant effect on the total RFS and RSI ratings.
Conclusion: There is specificity in the RSI and RFS as diagnostic materials for LPR.
However, there may be an incidence of over diagnosis. Factors such as age, smoking,
professional voice use and gender must be considered in diagnosis.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/9775
Date16 May 2011
CreatorsLogan, Jeanneane
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf, application/pdf, application/octet-stream

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