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Du et al

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give them the advisement on changing lifestyle, particularly
on diet and physical exercise, also we should follow them
up to learn if the pH monitoring result turn to be positive in
the future.
Moreover, our results show that there were significant differences between the negative and control group in the true
vocal fold regions, but no significant difference in both false
vocal folds regions. This phenomenon was also reported by
Hanson et al, who thought that the vocal fold regions were
much more sensitive to the acid.12
While reflux finding score (RFS) covers only a few characteristics of a laryngoscope image and is judged subjectively,
image analysis based on computer recognition and machinelearning could process the images with more objective and
comprehensive parameters. Furthermore, this method gives
us a possibility to grade the LPR disease. Although there may
be biases of such as different angles, distance, or luminance,
they affect the RFS either. Future work should focus on collecting more patients and tracing changes in laryngoscopic images,
including studies within the negative group.
There are some limitations of this study. There was not a
consensus on diagnosing LPRD through MII-24 h pH monitoring. The normative values for all parameters acquired during
MII-24 h pH monitoring have not been established yet.5
Furthermore, there was still the possibility of a misdiagnosis
to the false positive and false negative results.16 Finally,
MII-24 h pH monitoring was regarded as a poor predictor of
the severity of patients' symptoms and signs, which should have
helped us to determine the developing stage of the disease.17

4.
5.

10.

Conclusion
This study further demonstrates that hue values of separate
laryngeal regions are different. In negative group, the hue values of interarytenoid region are similar with positive group, and
the sensitivity to the acid are different from different regions.
The sensitivity in the true vocal folds may be present.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.

11.
12.

13.
14.

Funding
The author(s) disclosed receipt of the following financial support for
the research, authorship, and/or publication of this article: This study
was supported by Beijing Health Promotion Association, A71490-05.
The authors have no other funding, financial relationships, or conflicts
of interest to disclose.

15.

16.

ORCID iD
Yan Yan

https://orcid.org/0000-0002-7924-8070

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https://www.orcid.org/0000-0002-7924-8070 https://www.orcid.org/0000-0002-7924-8070 https://www.orcid.org/0000-0002-7924-8070

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