Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy.

ABSTRACT

OBJECTIVE: To determine if degree of lingual tonsil hypertrophy (LTH) correlates with pharyngeal reflux. DESIGN: Prospective. METHODS: Patients with flexible laryngoscopic evidence of LTH were included. Degree of LTH was graded mild, moderate, or severe by two otolaryngologists blinded to pH study results. Three-sensor pH study results were correlated to LTH grade. RESULTS: Nineteen patients were included (five with mild LTH, eight with moderate LTH, and six with severe LTH). Nasopharyngeal reflux (NPR) events patients but no mild or moderate LTH patients (P = 0.006). All severe LTH patients had NPR events patients (P = 0.017). At the UES, 4 of 6 severe LTH patients had pathologic reflux, compared with 4 of 13 mild or moderate (P = 0.025). Interobserver reliability calculated by Cohen's kappa was excellent (0.92).

CONCLUSIONS:

Our study shows a continuum of increasing pharyngeal reflux with higher LTH severity. Severe LTH may be a reliable physical sign of pharyngeal reflux, especially NPR.