Authors: Erdem Eren Seçil Arslanoğlu Ayşe Aktaş Aylin Kopar Ejder Ciğer Kazım Önal Hüseyin Katılmiş
Publish Date: 2013/09/03
Volume: 271, Issue: 4, Pages: 743-747
Abstract
The objective of the study was to determine the interrater variability in assessment of laryngeal findings and whether diagnosing laryngopharyngeal reflux based on the laryngeal findings and history alone without considering allergic rhinitis leads to the overdiagnosis and overtreatment of laryngopharyngeal reflux Patients with positive and negative skin prick tests were recruited from an allergy clinic in a tertiary teaching university hospital All subjects completed the Reflux Symptom Index RSI and underwent laryngeal examinations by three physicians blinded to the skin prick test results and the Reflux Finding Score RFS was determined RFS 7 or RSI 13 was considered reflux positive Fleiss’ kappa κ was used to measure interrater agreement The interrater agreement was low for pseudosulcus vocalis κ = 0078 ventricular obliteration κ = 0206 diffuse laryngeal edema κ = 0204 and posterior laryngeal hypertrophy κ = 027 intermediate for laryngeal erythema/hyperemia κ = 042 and vocal fold edema κ = 042 and high for thick endolaryngeal mucus κ = 061 Although the frequency of allergy was high there was no significant difference between allergypositive and laryngopharyngeal refluxpositive patients On logistic regression analysis thick endolaryngeal mucus was a significant predictor of allergy p = 0012 odds ratio 0264 95 confidence interval 0093–074 The laryngeal examination for reflux is subject to marked interrater variability and allergic laryngitis was not misdiagnosed as laryngopharyngeal reflux The presence of thick endolaryngeal mucus should alert physicians to the possibility of allergic rhinitis/laryngitis
Keywords: