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J Korean Soc Laryngol Phoniatr Logop > Volume 18(2); 2007 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2007;18(2): 96-101.
역류증상지수와 역류소견점수의 타당성과 신뢰도
이병주, 왕수건, 이진춘
부산대학교 의학전문대학원 이비인후과학교실
The Validity and Reliability of Reflux Symptom(RSI) Index and Reflux Finding Score(RFS)
Byung-Joo Lee, Soo-Geun Wang, Jin-Choon Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine
ABSTRACT
Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.
KEY WORDS: Laryngopharyngeal reflux;Laryngoscopy;Symptom;
중심 단어: 인후두역류;역류증상지수;역류소견점수;
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