Lechien Jerome R
Polyclinic of Poitiers, Elsan Hospital, 86000 Poitiers, France.
Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium.
J Clin Med. 2022 Sep 1;11(17):5192. doi: 10.3390/jcm11175192.
Purpose: To investigate the prevalence of symptoms and signs of laryngopharyngeal reflux (LPR) and to compare them with the otolaryngologist-estimated prevalence of the most common LPR-related symptoms and signs. Methods: The prevalence of LPR symptoms and signs was determined through the clinical data of 403 patients with a positive LPR diagnosis on hypopharyngeal−esophageal multichannel intraluminal impedance pH monitoring. The otolaryngologist-estimated prevalence was assessed through an international survey investigating the thoughts of 824 otolaryngologists toward LPR symptom and sign prevalence. The determination of potential over- or underestimation of LPR symptoms and findings was investigated through a data comparison between the ‘true’ prevalence and the ‘estimated prevalence’ of symptoms and findings by otolaryngologists. Results: The prevalence of breathing difficulties, coated tongue, and ventricular band inflammation was adequately evaluated by otolaryngologists. The prevalence of hoarseness, throat pain, odynophagia, dysphagia, throat clearing, globus sensation, excess throat mucus, tongue burning, heartburn, regurgitations, halitosis, cough after eating or lying down, and troublesome cough was overestimated by otolaryngologists (p < 0.01), while the prevalence of chest pain was underestimated as an LPR symptom. Most laryngeal signs, e.g., arytenoid/laryngeal erythema, inter-arytenoid granulation, posterior commissure hypertrophy, retrocricoid edema/erythema, and endolaryngeal sticky mucus, were overestimated (p < 0.01). The occurrence of anterior pillar erythema and tongue tonsil hypertrophy was underestimated by participants. Conclusion: Most laryngopharyngeal reflux symptoms and laryngeal signs were overestimated by otolaryngologists, while some non-laryngeal findings were underestimated. Future studies are needed to better understand the reasons for this phenomenon and to improve the awareness of otolaryngologists toward the most and least prevalent reflux symptoms and signs.
调查喉咽反流（LPR）症状和体征的患病率，并将其与耳鼻喉科医生估计的最常见LPR相关症状和体征的患病率进行比较。方法：通过下咽-食管多通道腔内阻抗pH监测确诊为LPR阳性的403例患者的临床资料，确定LPR症状和体征的患病率。通过一项国际调查评估耳鼻喉科医生估计的患病率，该调查调查了824名耳鼻喉科医生对LPR症状和体征患病率的看法。通过比较“真实”患病率与耳鼻喉科医生对症状和体征的“估计患病率”的数据，研究LPR症状和发现可能被高估或低估的情况。结果：耳鼻喉科医生对呼吸困难、舌苔、室带炎症的患病率评估准确。耳鼻喉科医生高估了声音嘶哑、咽痛、吞咽痛、吞咽困难、清嗓、球部感觉异常、咽喉部黏液过多、舌灼痛、烧心、反流、口臭、进食或躺下后咳嗽以及顽固性咳嗽的患病率（p<0.01），而胸痛作为LPR症状的患病率被低估。大多数喉部体征，如杓状软骨/喉部红斑、杓间区颗粒形成、后联合肥大、环状软骨后水肿/红斑和喉内黏性黏液，被高估（p<0.01）。参与者低估了前柱红斑和舌扁桃体肥大的发生率。结论：耳鼻喉科医生高估了大多数喉咽反流症状和喉部体征，而一些非喉部表现被低估。需要进一步研究以更好地理解这一现象的原因，并提高耳鼻喉科医生对最常见和最不常见反流症状和体征的认识。
