The Relationship Among Perceptual And Objective Reflux Measures In Singers

Laryngopharyngeal reflux (LPR) is currently one of the most prevalent conditions associated with voice disorders being treated in voice care centers worldwide. Many singers experience voice related disturbances but are unaware that these disturbances may be the result of LPR. The purpose of this study was to quantify the perceptual symptoms and objective measures of LPR in a population of singers in order to understand the relationship between perceived symptoms, laryngeal findings, and evidence of acid exposure to the larynx. The Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and the Dx-pH monitoring system were used to quantify participant symptoms, endoscopic findings, and pH levels in the oropharynx. The population included 12 semi-professional and professional singers. Significant correlations were found between the RFS, RSI and pH mild and moderate pH levels. This indicates that singers are sensitive to even small deviations of pH and this should be taken into consideration when evaluating a singers who have suspected LPR. Due to the variety of etiologies that can produce the symptoms and physical findings mentioned in this study, it is imperative that more objective data be obtained to confirm the presence of reflux in the oropharynx. As such, endoscopic findings and symptoms alone are not a good indication of reflux exposure and more objective data, like an oropharyngeal pH measurement system, should be implemented to quantify reflux in the oropharynx. The RSI and the RFS are valid tools for qualifying perceptions and physical findings however they are not without flaws