A study on the role of videostroboscopy in the early detection of laryngeal changes in patients with laryngopharyngeal reflux disease

Abstract

Background: Laryngopharyngeal reflux disease (LPRD) is a common cause of chronic throat and voice symptoms and often produces subtle mucosal and vibratory abnormalities that may not be detected on routine laryngoscopy. Videostroboscopy provides dynamic assessment of vocal fold function and may improve early diagnosis and severity stratification. Objective: To evaluate the diagnostic utility of videostroboscopy in detecting structural and functional laryngeal abnormalities and to determine its association with symptom severity and treatment outcomes in patients with suspected LPRD. Methodology: This was a prospective cross-sectional observational study conducted at the Department of Otorhinolaryngology, BLDEU’s Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, over the defined study period, including 136 patients with symptoms suggestive of laryngopharyngeal reflux disease (LPRD). Results: Females constituted 62.5% of participants. The mean RSI score was 21.05. Moderate LPR was most common (42.65%), followed by mild (27.21%), no/borderline (15.44%), and severe disease (14.71%). ENT examination revealed inflammatory changes in 86.76% of patients, with cobblestoning (25%) and erythema (20.59%) being frequent findings. Videostroboscopy demonstrated reduced vibratory amplitude and mucosal wave in 57.35% of patients, while abnormalities in symmetry, periodicity, and glottic closure were observed in all cases (100%). Reduced amplitude was present exclusively in moderate and severe disease, showing a strong association with severity (χ² = 272.00, p < 0.0001). At one-month follow up, 75% of patients improved clinically. Conclusion: Videostroboscopy detects early and widespread functional vocal fold abnormalities and correlates strongly with disease severity, making it a valuable adjunct to routine ENT examination for accurate diagnosis, grading, and follow-up of patients with laryngopharyngeal reflux disease.