Diagnosis and grading of laryngopharyngeal reflux disease with narrow band imaging: preliminary study

Purpose Laryngopharyngeal reflux (LPR) disease is a common problem usually diagnosed with white light laryngoscope and questionnaires. Some studies have proposed Narrow band imaging (NBI) laryngoscopy as a useful method for diagnosing LPR. The aim of this preliminary study was to evaluate the potential use of NBI for the diagnosis and grading of LPR disease. Methods All patients underwent to the Reflux Symptom index (RSI) questionnaire and white light laryngoscope evaluation calculating Reflux Findings Score (RFS). Patients evaluated with white light laryngoscope with RFS ≥7 were enrolled in Group A, while patients with RFS <7 were enrolled in Group B. A comparison of both RFS scores, calculated with white light and NBI, was performed and patients affected by LPR visible only with NBI system were identified. NBI score was performed to improve the evaluation of LPR signs including a grading score that could help to classify different types of LPR damages. Results Analysing the data of RFS estimated with white light, it was possible to diagnose LPR in 65% of patients enrolled in the study. In contrast RFS evaluated with NBI showed 88% of patients affected by LPR. Difference between resulted was statistically different. In group A, 64% presented a Grade 3 NBI score, 35% Grade 2 and none of the patients Grade 1. In group B, 33% presented a Grade 1 NBI score, 55% Grade 2 and 11% Grade 3. Conclusion Results of this preliminary study suggest that NBI could improve the identification and the grading of LPR signs.