Factors confusing the diagnosis of laryngopharyngeal reflux: The role of allergic rhinitis and inter-rater variability of laryngeal findings

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dc.contributor.authorEren E.
dc.contributor.authorArslanoǧlu S.
dc.contributor.authorAktaş A.
dc.contributor.authorKopar A.
dc.contributor.authorCiǧer E.
dc.contributor.authorÖnal K.
dc.contributor.authorKatilmiş H.
dc.date.accessioned2024-07-22T08:17:24Z
dc.date.available2024-07-22T08:17:24Z
dc.date.issued2014
dc.description.abstractThe objective of the study was to determine the inter-rater 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 inter-rater agreement. The inter-rater agreement was low for pseudosulcus vocalis (κ = 0.078), ventricular obliteration (κ = 0.206), diffuse laryngeal edema (κ = 0.204), and posterior laryngeal hypertrophy (κ = 0.27), intermediate for laryngeal erythema/hyperemia (κ = 0.42) and vocal fold edema (κ = 0.42), and high for thick endolaryngeal mucus (κ = 0.61). Although the frequency of allergy was high, there was no significant difference between allergy-positive and laryngopharyngeal reflux-positive patients. On logistic regression analysis, thick endolaryngeal mucus was a significant predictor of allergy (p = 0.012, odds ratio 0.264, 95 % confidence interval 0.093-0.74). The laryngeal examination for reflux is subject to marked inter-rater 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. © 2013 Springer-Verlag.
dc.identifier.DOI-ID10.1007/s00405-013-2682-y
dc.identifier.issn09374477
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/17053
dc.language.isoEnglish
dc.publisherSpringer Verlag
dc.subjectAdult
dc.subjectCohort Studies
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHumans
dc.subjectLaryngeal Edema
dc.subjectLaryngitis
dc.subjectLaryngopharyngeal Reflux
dc.subjectLaryngoscopy
dc.subjectLarynx
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectObserver Variation
dc.subjectProspective Studies
dc.subjectRhinitis, Allergic, Perennial
dc.subjectVocal Cords
dc.subjectYoung Adult
dc.subjectadult
dc.subjectallergic rhinitis
dc.subjectarticle
dc.subjectcontrolled study
dc.subjectcoughing
dc.subjectdysphonia
dc.subjectfemale
dc.subjecthuman
dc.subjectlaryngeal erythema
dc.subjectlaryngeal hyperemia
dc.subjectlaryngeal hypertrophy
dc.subjectlaryngitis
dc.subjectlaryngopharyngeal reflux
dc.subjectlarynx disorder
dc.subjectlarynx edema
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical history
dc.subjectmucus
dc.subjectnamed inventories, questionnaires and rating scales
dc.subjectprick test
dc.subjectpriority journal
dc.subjectreflux finding score
dc.subjectReflux Symptom Index
dc.subjectsingle blind procedure
dc.subjectskin test
dc.subjectteaching hospital
dc.subjectuniversity hospital
dc.titleFactors confusing the diagnosis of laryngopharyngeal reflux: The role of allergic rhinitis and inter-rater variability of laryngeal findings
dc.typeArticle

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