Predictive value of laryngeal pseudosulcus for gastroesophageal reflux in pediatric patients

To determine if the presence of laryngeal pseudosulcus is a good predictor of reflux in children. A retrospective review of clinical photographs of 66 children undergoing direct laryngoscopy for airway symptoms for the presence of laryngeal pseudosulcus. Its presence was correlated with positive reflux tests: 24 h pH monitoring, gastric scintiscan, barium swallow, and esophageal biopsy. Fifty-six patients had a positive reflux test, and 89% of these had pseudosulcus. Seventy percent of the reflux-negative group ( N = 10) had no pseudosulcus. Sensitivity and specificity were 89% and 70%, respectively. On its own the presence of pseudosulcus has marginal predictive use, but it is found more frequently among reflux-positive children and may be a useful marker to add to existing visual scoring systems.