Voice Disorders in Patients With Discordant RFS and RSI Scores.

Abstract

Background: Laryngopharyngeal reflux (LPR) is a significant risk factor for various voice disorders. The reflux finding score (RFS) and Reflux Symptom Index (RSI) are widely used diagnostic tools for LPR, but they often show poor concordance. It remains unclear whether patients with discordant RFS and RSI scores (one positive, one negative) have a higher risk of developing voice disorders, and whether proton pump inhibitor (PPI) therapy can improve voice quality in this subgroup.

Objective: This study aims to evaluate the risk of developing voice disorders in patients with discordant RFS and RSI scores and to assess the efficacy of PPI therapy on voice-related symptoms and objective voice parameters.

Study design: This study consists of a large-sample logistic regression analysis followed by a case-control phase and a prospective interventional phase.

Methods: Logistic regression analysis was performed on 915 patients, followed by telephone follow-up of 200 patients. A case-control study was conducted on these 200 patients, with a subsequent multivariate logistic regression analysis. A prospective study assessed the effects of PPI therapy on voice symptoms and objective voice parameters.

Results: Logistic regression analysis suggested that the risk of developing voice disorders in this subgroup was significantly higher compared with patients with both negative scores. PPI therapy led to significant reductions in the Voice Handicap Index (VHI), and GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scores in this subgroup, alongside enhancements in several objective voice parameters.

Conclusion: Discordant RFS and RSI scores are associated with an increased risk of voice disorders. PPI therapy alleviates symptoms and improves voice quality, suggesting benefits for managing voice disorders in this subgroup.