The Usefulness of Esophagography as a Screening Test for Laryngopharyngeal Reflux

ABSTRACT

PURPOSE: There are many articles about the role of barium esophagography for the diagnosis of gastroesophageal reflux disease. However, there are only rare articles reporting on laryngopharyngeal reflux disease. The purpose of this study is to evaluate the usefulness of performing esophagography with the water-siphon test as an initial screening test for patients with suspected laryngopharyngeal reflux. MATERIALS AND METHODS: From October 2002 to December 2004, barium esophagography with the water-siphon test was performed for 707 patients who had the typical symptoms and telescopic findings of laryngopharyngeal reflux. The results of the 707 esophagograms (the group with laryngopharyngeal reflux) were compared with those of 122 patients who were confirmed as having gastroesophageal reflux upon performing pH-metry (the group with gastroesophageal reflux) and the 324 patients without laryngopharyngeal reflux symptoms (the control group). The results of the water-siphon test were classified into normal, mild, moderate and severe degrees of gastroesophageal reflux. RESULTS: On the water-siphon test for the laryngopharyneal reflux group patients, 71 patients had normal (10.0%), 207 had mild (29.2%), 201 had moderate (28.4%) and 228 had severe (32.2%) degrees of reflux. The positive rates of the water-siphon test were 90.0%, 89.3% and 54.6% for the groups with laryngopharyngeal reflux, gastroesophageal reflux and the control group, respectively. A statistically significant difference was observed between the group with laryngopharyngeal reflux and the control group, and between the group with gastroesophageal reflux and the control group, respectively (p>0.05). CONCLUSION: Esophagography with the water-siphon test is useful as an initial screening test for laryngopharyngeal reflux disease.