The association between laryngeal pseudosulcus and laryngopharyngeal reflux

Laryngopharyngeal reflux (LPR) is a common ailment that represents a causative or exacerbating factor for many disorders of the upper aerodigestive tract. Despite increasing knowledge of its existence and pathophysiologic mechanisms, the diagnosis of LPR may be illusive. Ambulatory 24-hour double-probe pH monitoring with the proximal probe just above the upper esophageal sphincter is the current “gold standard” for the diagnosis of LPR. This modality is expensive, time consuming, and uncomfortable for some patients.

A physical finding predictive of LPR would be clinically beneficial. We have developed an 8-item physical finding score for LPR.  It assists the clinician in documenting LPR severity as well as in evaluating treatment efficacy. In our experience, the presence of laryngeal pseudosulcus is one of the most reliable predictors included in the finding score . A recent study by Hickson et al reported a positive predictive value of 90% for pseudosulcus in the diagnosis of LPR. Although this investigation did not include a control group, they concluded that pseudosulcus is an accurate predictor of LPR disease.  The purpose of this investigation was to evaluate the prevalence, sensitivity, and specificity
of pseudosulcus among patients with LPR.

Read: The association between laryngeal pseudosulcus and laryngopharyngeal reflux


PETER C. BELAFSKY, MD, PhD, GREGORY N. POSTMA, MD, and JAMES A. KOUFMAN, MD, Winston-Salem, North Carolina

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