The importance of laryngoscopic findings as predictors of the treatment outcomes of laryngopharyngeal reflux: a retrospective review of 143 cases

S, J. N, B. V. Prevalance of Iron Deficiency Anaemia in Laryngopharyngeal Reflux

AIM

To determine the correlation of iron deficiency anaemia (IDA) in patients diagnosed with Laryngo Pharyngeal Reflux Disease (LPRD).

MATERIALS AND METHODS

100 patients who presented to the OPD, diagnosed to have LPRD based on the Reflux Symptom Index (score > 13) and the Reflux Findings Score (score > 9), were subjected to a Complete Blood count and Peripheral smear examination to look for indices suggestive of an Iron deficiency state or anaemia.

RESULTS

58% (58) of the patients included in the study had Hb less than 11.5 g/dl with an average Hb of 11 g/dl. 93% (93) had PCV < 40%, and 94% (94) had elevated RDW (> 14.5%). 53% of the patients included had low MCV, MCH, and MCHC. 53% of the patients showed features of microcytic hypochromic RBCs on the peripheral smear. Elevated RDW can be used as an indicator of an iron-deficient state in populations with a high prevalence of IDA, like India.

CONCLUSION

The study shows a strong correlation between LPRD and an Iron deficient state. However, whether iron deficiency is the cause or effect of LPRD needs to be determined further. Further research in this area could shed light on the pathophysiology of LPRD and have implications for its treatment.

Resource utilization and variation among practitioners for evaluating voice hoarseness secondary to suspected reflux disease: A retrospective chart review

The purpose of this study was to assess the variation in resource utilization for the diagnosis and treatment of dysphonia or hoarseness in patients with suspected laryngopharyngeal reflux (LPRD) and/or gastroesophageal reflux (GERD). Secondary data was collected from a single-institution database of charts from patients evaluated between October 1, 2011 and March 31, 2020. This study was conducted as a retrospective chart review. Key outcome variables included demographic data, initial specialty visit, date of first symptom evaluation to final follow-up visit, additional procedural evaluation, and final diagnosis as attributed by the diagnosing physician. Inclusion criteria included patients ≥18 older referred to providers for suspected LPRD/GERD with a primary complaint of voice changes or hoarseness and appeared for follow-up. A total of 134 subjects were included for analysis. Data analysis included descriptive and univariate analysis, chi-square test of independence, independent means t test, and 1-way analysis of variance. Most patients (88) received some form of procedural evaluation in addition to clinical evaluation. The most frequent was videostroboscopy (59). Patients who first visited a gastroenterologist were more likely to undergo esophageal pH-monitoring (n = 14, P < .001) and manometry (n = 10, P < .001). Patients referred to speech-language pathology were very likely to undergo videostroboscopic evaluation (n = 7, P < .001). The prevailing final diagnosis as attributed by the diagnosing physician was confirmed to be of non-reflux etiology (49) or due to GERD alone (34). LPRD only was the least frequent diagnosis (10). Our results demonstrate that there is significant variation in the number and type of diagnostic tests based on the type of practitioner initially seen by the patient. Additionally, of patients thought to have voice change or hoarseness because of LPRD and/or GERD, more than a third had a non-reflux cause of their symptoms. Further research should identify beneficial patterns in resource utilization and further diagnostic utility of diagnostic procedures for more accurate diagnosis.