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Reflux Finding Score (RFS) of Belafsky et al for Grading Laryngopharyngeal Reflux Disease

Purpose: To grade the severity of findings on laryngoscopy in a patient with laryngopharyngeal reflux of gastric contents.

Description

Patients with reflux disease may have gastric acid enter the upper airway (laryngopharyngeal reflux disease), with chronic cough and other symptoms. Belafsky et al developed the Reflux Finding Score (RFS) to grade the severity of changes seen during laryngoscopy. The authors are from Wake Forest University in Winston-Salem, North Carolina.


Parameters:

(1) subglottic edema

(2) ventricular obliteration

(3) erythema and hyperemia

(4) vocal cord edema

(5) diffuse laryngeal edema

(6) posterior commissure hypertrophy

(7) granuloma and/or granulation tissue

(8) thick endolaryngeal mucus

 

Parameter

Finding

Points

subglottic edema

absent

0

 

present

2

ventricular obliteration

absent

0

 

partial

2

 

complete

4

erythema and hyperemia

absent

0

 

arytenoids only

2

 

diffuse

4

vocal cord edema

none

0

 

mild

1

 

moderate

2

 

severe

3

 

polypoid

4

diffuse laryngeal edema

none

0

 

mild

1

 

moderate

2

 

severe

3

 

obstructing

4

posterior commissure hypertrophy

none

0

 

mild

1

 

moderate

2

 

severe

3

 

obstructing

4

granuloma/granulation tissue

absent

0

 

present

2

thick endolaryngeal mucus

absent

0

 

present

2

 

where:

• The paper includes laryngoscopic views to demonstrate the changes seen.

 

reflux finding score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 26

• A score > 7 indicated laryngopharyngeal reflux.

• The higher the score, the more severe the changes.


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Specialty

Objective

ICD-10