DAVID LAU, MD; MURRAY MORRISON, MD; LINDA RAMMAGE, PHD
VANCOUVER, CANADA

Gastroesophageal reflux (GER) contributes significantly to the pathogenesis of voice disorders. Ambulatory double-probe pH monitoring, the diagnostic gold standard, is not always practical. Diagnosis is usually based on history and examination, and therapy is often empirical. While posterior laryngitis is associated with GER, and videolaryngoscopy scores and quantitative color analysis show improvement with reflux treatment, the ability of videolaryngoscopy to predict GER is not well documented. This study aimed to determine the ability of videolaryngoscopy to diagnose GER by blinded review of videolaryngoscopic recordings in patients undergoing ambulatory double-probe pH monitoring. The recordings, taken prior to initiating antireflux therapy, were spliced onto one S-VHS tape in random order. Two laryngologists and a speech pathologist rated the recordings after learning a scoring system. Intra-observer and interobserver variations were assessed. Differences between reflux and nonreflux groups were analyzed statistically. Conclusions were made regarding the ability of videolaryngoscopy to diagnose GER.