Laryngopharyngeal Reflux: Inter-rater Reliability of Reflux Finding Score in Clinical Practice

Abstract

Introduction Laryngopharyngeal reflux (LPR) is a clinical entity, caused due to retrograde flow of gastric content into the larynx. It imposes great diagnostic challenge to clinicians because of lack of specific symptoms, signs and validated tool. Reflux Finding Score (RFS) has been proposed for clinical diagnosis of LPR. Inter observer reliability of RFS tool was found out using two independent observers Materials and Methods In this Cross sectional study, ninety LPR subjects were subjected to 90° rigid endoscopic examination of larynx and RFS scores were calculated by two observers. Inter observer reliability of RFS was calculated using Kappa value. Results Most commonly observed laryngeal findings were erythema/hyperemia, posterior commissure hypertrophy, and vocal fold edema. Subglottic edema, thick endolaryngeal mucus and erythema had fair agreement. Conclusion There was a poor agreement between observers for total RFS score. The variables like subglottic edema, erythema/hyperemia, and thick endolaryngeal mucus showed fair agreement between the raters. The findings of diffuse laryngeal edema and posterior commissure hypertrophy showed poor inter rater reliability.

Keywords

• laryngopharyngeal reflux
• reflux finding score
• endoscopy