Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Laryngoscope. 2013 Apr;123(4):985-91. doi: 10.1002/lary.23693. Epub 2012 Dec 3.
OBJECTIVES/HYPOTHESIS: A literature review regarding the use of laryngopharyngeal mucosal signs in diagnosing laryngopharyngeal reflux (LPR).
Literature review.
A search of MEDLINE in February 2012 using the terms laryngopharyngeal reflux, laryngitis, mucosa, appearances, and signs (English language only).
One or more laryngopharyngeal mucosal signs associated with LPR were identified in 64% to 93% of healthy volunteers (3% >5 signs) and in 17% to 85% of gastroesophageal reflux disease sufferers (Reflux Finding Score [RFS] >7 in 24%). Reinke's edema, pseudosulcus, ventricular obliteration, vocal cord nodules, and granulomas have in some, but not all studies, been shown to be more prevalent in those with pH-proven pharyngeal reflux. Pseudosulcus, interarytenoid thickening, and Reinke's edema were more prevalent in those symptomatic of LPR than those not. The use of multiple mucosal signs may improve detection of reflux sufferers from asymptomatic controls. The RFS has a sensitivity and specificity of 87.8% and 37.5%, respectively, for picking up pH-proven pharyngeal reflux individuals. Inter- and intrarater reliability for identifying signs is fair to good in most studies.
The limited evidence for each mucosal finding should be considered in making the diagnosis of LPR. Further quality research in to mucosal findings in LPR is needed.
目的/假设：对诊断喉咽反流（LPR）时使用喉咽黏膜征象的文献进行综述。
文献回顾。
2012 年 2 月在 MEDLINE 上使用术语“喉咽反流”、“喉炎”、“黏膜”、“表现”和“征象”（仅英语）进行搜索。
在 64%至 93%的健康志愿者（3% >5 种征象）和 17%至 85%的胃食管反流病患者（反流发现评分[RFS] >7 分占 24%）中发现一种或多种与 LPR 相关的喉咽黏膜征象。在一些但不是所有研究中，Reinke 水肿、假性沟、室带消失、声带小结和肉芽肿的发生率在 pH 证实的咽反流患者中更高。假性沟、杓状软骨间区增厚和 Reinke 水肿在 LPR 症状患者中比无症状患者更常见。使用多种黏膜征象可能提高从无症状对照者中检测出反流患者的能力。RFS 对 pH 证实的咽反流患者的敏感性和特异性分别为 87.8%和 37.5%。在大多数研究中，识别征象的组内和组间可靠性为中等至良好。
在做出 LPR 诊断时，应考虑每种黏膜征象的有限证据。需要进一步开展有关 LPR 黏膜征象的高质量研究。
