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Multicenter Study
. 2006 Oct;26(5):264-70.

Multicentric study: statistical correlation between clinical data and instrumental findings in laryngo-pharyngeal reflux: proposal for a new ENT classification of reflux

C A Leone  1 , F Mosca
Affiliations
Multicenter Study

Multicentric study: statistical correlation between clinical data and instrumental findings in laryngo-pharyngeal reflux: proposal for a new ENT classification of reflux

C A Leone et al. Acta Otorhinolaryngol Ital. 2006 Oct.

Abstract
in English, Italian

Clinical pictures of laryngopharyngeal reflux, described in the literature, often differ considerably and are described with wide severity. Some classifications employ a total score i.e., addition of the assigned scores to single aspects of video-laryngoscopy. These classifications have the disadvantage of being complex, not reproducible and, in part, subjective. In this study, an original video-laryngoscopic classification is proposed, based on a topographic criterion with distinction of anterior, from posterior and lateral, lesions and an anatomo-pathological criterion that assigns a marked severity to the granulomatous and erosive lesions, in comparison with the erythematous and oedematous lesions. Four classes are proposed or grades of patients (A, B, C, D). The study was multicentric on 178 patients. Results were considered estimating the clinical parameters and the symptoms, correlating them at the stages of the classification proposed. The data obtained indicate that our classification presents an indicative distribution as far as concerns severity and it seems acceptable for efficacy and simplicity: no significant correlation emerged between the single manifestations and the severity of the objective picture; in the majority of cases, the most constant symptomatological triad was globus, cough and dysphonia.

I quadri clinici descritti in letteratura del reflusso faringolaringeo sono spesso molto diversi e vengono descritti con gravità molto varie. Esistono alcune classificazioni che producono un punteggio complessivo costituito dalla somma di punteggi assegnato a singoli aspetti della videolaringoscopia. Queste classificazioni hanno lo svantaggio di essere complesse, non riproducibili ed in parte soggettive. In questo studio viene proposta una classificazione videolaringoscopica originale basata su un criterio topografico che distingue le lesioni anteriori da quelle posteriori e laterali e un criterio anatomopatologico che assegna maggiore gravità alle lesioni granulomatose ed erosive rispetto a quelle eritematose ed edematose. Vengono proposte quattro classi o gradi di pazienti (A, B, C, D). Lo studio è stato multicentrico su 178 pazienti. Sono stati considerati i risultati valutando i parametri clinici e i sintomi, correlandoli agli stadi della classificazione proposta. I dati emersi indicano che la nostra classificazione presenta una distribuzione indicativa di una progressione per gravità e sembra accettabile per efficacia e semplicità. Non emerge una correlazione significativa tra le singole manifestazioni e la gravità del quadro obiettivo e nella maggioranza dei casi del nostro campione la triade sintomatologica più costante è stata il globo, la tosse e la disfonia.

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Figures

Fig. 1
Fig. 1
Percentages in the groups studied.
Fig. 2
Fig. 2
Example of grade A: interarytenoid oedema with reflux in right pyriform sinus.
Fig. 3
Fig. 3
Example of grade B: erythema in anterior regions.
Fig. 4
Fig. 4
Example of grade C: posterior granuloma.
Fig. 5
Fig. 5
Example of grade D: postero-anterior granuloma.
Fig. 6
Fig. 6
Same case in Figure 5 after PPI therapy.
Fig. 7
Fig. 7
A typical reflux from esophagus.
See this image and copyright information in PMC

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