A Study of Correlation between Customized Reflux Symptom Scoring with Video Laryngopharyngoscopic Findings for Developing a Management Protocol for Laryngopharyngeal Reflux Disease in South Indian Population

original rESEarCHin the western context, but it is not practically feasible in the Indian scenario due to prohibitive cost and poor compliance.Endoscopically, LPR can be suspected if there is erythema and hypertrophy of the epiglottis, arytenoids, ventricular bands, IntroductIonLaryngopharyngeal reflux (LPR) is a silent entity which disrupts the mucosal barrier and alters pH in the laryngopharynx.This can occur as an isolated phenomenon or it can coexist with gastroesophageal reflux disease (GERD).It is an inflammatory disease, a variant of extraoesophageal reflux where the backflow of gastric and duodenal contents, that is, acidic bile and other acidic or nonacidic gaseous contents, reflux into the larynx (Figs 1 to 7). 1 Prevalence of LPR in the Indian subcontinent is estimated to be 11%, with equal gender distribution, mostly affecting agegroups between 40 and 50 years.Although there is a huge overlap of symptoms and signs between LPR and GERD, LPR is routinely suspected when there is voice change, dysphagia, clearing throat frequently, chronic cough, throat irritation, globus pharynges with thick mucus. 2 LPR is implicated to cause interarytenoid banding (Fig. 8), chronic laryngitis, arytenoid granuloma (Figs 9 and 10), ventricular bands, subglottis stenosis, vocal nodules, contact ulcers, and carcinoma in situ in prolonged reflux. 3 Diagnosis of LPR is arrived at by correlating the patient's history, symptoms, and office-based videolaryngopharyngoscopic examination.Twenty-four hours impedance pH monitoring gives us much more reliable results. 4 This has been proven