Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy
Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, September 18, 2007, Washington, DC.
Received 6 September 2007; received in revised form 12 December 2007; accepted 18 December 2007.
Objective
To determine if degree of lingual tonsil hypertrophy (LTH) correlates with pharyngeal reflux.
Design
Prospective.
Methods
Patients with flexible laryngoscopic evidence of LTH were included. Degree of LTH was graded mild, moderate, or severe by two otolaryngologists blinded to pH study results. Three-sensor pH study results were correlated to LTH grade.
Results
Nineteen patients were included (five with mild LTH, eight with moderate LTH, and six with severe LTH). Nasopharyngeal reflux (NPR) events <pH4 were found in four of six severe LTH patients but no mild or moderate LTH patients (P = 0.006). All severe LTH patients had NPR events <pH5, compared with only 4 of 11 mild or moderate LTH patients (P = 0.017). At the UES, 4 of 6 severe LTH patients had pathologic reflux, compared with 4 of 13 mild or moderate (P = 0.025). Interobserver reliability calculated by Cohen’s kappa was excellent (0.92).
Conclusions
Our study shows a continuum of increasing pharyngeal reflux with higher LTH severity. Severe LTH may be a reliable physical sign of pharyngeal reflux, especially NPR.
Department of Otolaryngology–Head and Neck Surgery, Emory University, Atlanta, GA.
Corresponding author: John M. DelGaudio, MD, Emory University School of Medicine, Department of Otolaryngology–Head and Neck Surgery 1365-A Clifton Road, NE, Atlanta, GA 30322.
ABSTRACT