Is pseudosulcus alone a reliable sign of gastroesophago‐pharyngeal reflux?

Is pseudosulcus alone a reliable sign of gastroesophago‐pharyngeal reflux? To investigate if laryngeal pseudosulcus (bilateral infraglottic oedema) is a reliable sign of pharyngeal reflux, the video recordings of 59 patients and 18 controls were examined off‐line by two phoniatricians. Eleven video segments were duplicated for calculation of intrarater reliability. The frequency of pseudosulcus was correlated to the results of 24‐h double‐probe pH monitoring. The intrarater reliability was moderate (K = 0.582; P = 0.005). The sensitivity of pseudosulcus in the diagnosis of pharyngeal reflux among the patients was 30% and among the controls it was 0%. The positive predictive value (PPV) of pseudosulcus for patients with pharyngeal and laryngeal symptoms was 67%, while for the controls it was 0%. The negative predictive value (NPV) of pseudosulcus for patients with pharyngeal or laryngeal symptoms was 32% and for the controls it was 64%. The single finding of pseudosulcus is not a very sensitive predictor of pharyngeal reflux but if the patient has laryngeal symptoms and a pseudsulcus, the probability that the patient has pharyngeal reflux is almost 70%.