Dynamics of the clinical and functional assessment of the larynx in patients with laryngopharyngeal reflux and gastroesophageal reflux disease against the background of antireflux therapy

Introduction. Given the clinical heterogeneity of laryngopharyngeal reflux (LFR) and the absence of universally accepted diagnostic criteria, comprehensive assessment of both subjective symptom dynamics and objective videolaryngostroboscopic (VLSS) findings during therapy is of particular importance.

Aim. To evaluate changes in the clinical and functional status of the larynx in patients with LFR and gastroesophageal reflux disease (GERD) receiving antireflux treatment, based on VLSS findings and the Reflux Finding Score (RFS) and Reflux Symptom Index (RSI) questionnaires.

Materials and methods. A total of 20 patients were examined, including 10 men and 10 women. Assessment was performed at three visits: before treatment, after 4–5 weeks, and after 8–9 weeks. At each visit, the Reflux Symptom Index (RSI) and Reflux Detection Score (RFS) data were assessed. All patients received pharmacological therapy consisting of a proton pump inhibitor at a standard dose for 4-8 weeks, along with lifestyle modification recommendations.

Results. At baseline, the median RSI was 15.5 points and the median RFS was 12.5 points. After 4 weeks, the median RSI decreased to 8.0 points, and after 8 weeks to 4.0 points. The median RFS decreased from 12.5 to 8.5 and 5.5 points after 4 and 8 weeks, respectively. The differences were statistically significant (p < 0.001). A clinically significant decrease in RSI of at least 30% was achieved in 95% of patients, while a clinically significant decrease in RFS was observed in 90%. By the end of follow-up, 85% of patients reached the threshold value of RFS ≤ 7.

Conclusions. Antireflux therapy in patients with LFR and GERD is associated with a marked reduction in subjective symptoms and laryngopharyngeal manifestations of the disease, as assessed by VLSS.

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