Abstract
OBJECTIVE
To evaluate the contribution of 24-hour pharyngeal pH monitoring for the patient presenting with symptoms of hoarseness, globus, throat clearing, and sore throat.
METHOD
Results of 167 pharyngeal pH studies performed for complaints of hoarseness, globus, and throat clearing at the Texas Center for Voice and Swallowing from 5/09-12/09 were analyzed for pharyngeal reflux pattern and severity. Patient records were reviewed for chief complaint, symptom duration, ten-item voice handicap index (VHI-10) and reflux symptom index (RSI) scores. MANOVA was used to compare symptom duration, VHI-10 scores, and RSI scores between those patients with and without abnormal pharyngeal pH studies.
RESULTS
72 studies (43%) were normal with zero events below pH 5.5. 59 studies (35%), or 60% of all positive studies showed nocturnal pharyngeal reflux only. 34 studies (20%) showed combination upright daytime reflux events and nocturnal reflux. Five studies (2%) had only upright events. There was no significant difference in presenting symptoms, symptom duration, or severity scores in the patients that had negative vs. positive pharyngeal pH studies.
CONCLUSION
24-hour pharyngeal pH study eliminates the diagnosis of reflux in a significant percentage of patients with hoarseness. Severity or duration of symptoms of hoarseness, globus, or throat clearing do not reliably predict presence of reflux.