Do laryngoscopic findings reflect the characteristics of reflux in patients with laryngopharyngeal reflux?

Lee, Y C; Kwon, Ohseong; Park, J M; Eun, Young Gyu

doi:10.1111/coa.12914

Cited by 24 publications

(30 citation statements)

References 21 publications

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“…Several findings, such as vocal fold erythema, leukoplakia, posterior pharyngeal wall inflammation, anterior pillar inflammation and coated tongue, are not included in the reflux finding score (RFS) and they were considered to be LPR-associated findings only to a certain extent (by about 10% to 60% of respondents). However, the findings associated with LPR may vary according to the type of reflux and patients' symptoms [26,27]. In addition, the physician's judgment is strongly influenced by his or her knowledge of the patient's complaint, which may help explain the low inter-rater reliability of the RFS [1].…”

Section: Discussionmentioning

confidence: 99%

Management of Laryngopharyngeal Reflux in Asia

Kim¹,

Lechien²,

Ayad³

et al. 2020

Clin Exp Otorhinolaryngol

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Objectives. This study was conducted to investigate the current practices of Asian otolaryngologists for laryngopharyngeal reflux (LPR).Methods. An online survey about LPR was sent to 2,000 members of Asian otolaryngological societies, and a subgroup analysis was performed between Western and Eastern Asian otolaryngologists. The survey was conducted by the Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies.Results. Among approximately 1,600 Asian otolaryngologists, 146 completed the survey (62 from Western Asian countries, 84 from Eastern Asian countries). A substantial majority (73.3%) of the otolaryngologists considered LPR and gastroesophageal reflux disease to be different diseases. The symptoms thought to be closely related to LPR were coughing after lying down, throat clearing, and globus sensation. The findings thought to be closely related to LPR were posterior commissure granulations and hypertrophy, arytenoids, and laryngeal erythema. The respondents indicated that they mostly diagnosed LPR (70%) after an empirical therapeutic trial of proton pump inhibitors (PPIs). Although multichannel intraluminal impedance-pH (MII-pH) monitoring is a useful tool for diagnosing nonacid or mixed LPR, 78% of Asian otolaryngologists never or very rarely used MII-pH. Eastern Asian otolaryngologists more frequently used once-daily PPIs (64.3% vs. 45.2%, <i>P</i>=0.021), whereas Western Asian otolaryngologists preferred to use twice-daily PPIs (58.1% vs. 39.3%, <i>P</i>=0.025). The poor dietary habits of patients were considered to be the main reason for therapeutic failure by Asian otolaryngologists (53.8%). Only 48.6% of Asian otolaryngologists considered themselves to be adequately knowledgeable and skilled regarding LPR.Conclusion. Significant differences exist between Western and Eastern Asian otolaryngologists in the diagnosis and treatment of LPR. Future consensus statements are needed to establish diagnostic criteria and therapeutic regimens.

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Section: Discussionmentioning

confidence: 99%

Management of Laryngopharyngeal Reflux in Asia

Kim¹,

Lechien²,

Ayad³

et al. 2020

Clin Exp Otorhinolaryngol

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“…With the development of impedance‐pH monitoring, an increasing number of physicians distinguish acid, non‐acid and mixed reflux; non‐acid and mixed reflux accounting for a substantial number of LPR patients . The efficacy of PPIs for LPR should be better for acid than non‐acid and mixed reflux, as PPIs do not limit refluxate mechanically but seek only to change its acid content .…”

Section: Discussionmentioning

confidence: 99%

The management of suspected or confirmed laryngopharyngeal reflux patients with recalcitrant symptoms: A contemporary review

Lechien

Muls

Dapri

et al. 2019

Clinical Otolaryngology

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Objective: To summarise current knowledge about the prevalence, aetiology and management of recalcitrant laryngopharyngeal reflux (LPR) patients-those who do not respond to anti-reflux medical treatment. Methods:A literature search was conducted following the PRISMA guidelines to identify studies that reported success of anti-reflux medical treatment with emphasis on studies that attempted to be rigorous in defining a population of LPR patients and which subsequently explored the characteristics of non-responder patients (ie aetiology of resistance; differential diagnoses; management and treatment). Three investigators screened publications for eligibility from PubMED, Cochrane Library and Scopus and excluded studies based on predetermined criteria. Design, diagnostic method, exclusion criteria, treatment characteristics, follow-up and quality of outcome assessment were evaluated.Results: Of the 139 articles screened, 45 met the inclusion criteria. The definition of non-responder patients varied substantially from one study to another and often did | 785 LECHIEN Et aL

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“…The development of MII-pH led to the identification of new subtypes of LPRD, being acid, weakly acid, mixed and nonacid LPRD. In that way, three recent studies found that the majority of patients have in fact nonacid or mixed LPRD[102-104]. The pathophysiological mechanisms of nonacid and mixed LPRD are still unknown but they could involve the activity of trypsin, conjugated and non-conjugated bile salts in the mucosa of the upper aerodigestive tract[1,105].…”

Section: Discussionmentioning

confidence: 99%

Treatment of laryngopharyngeal reflux disease: A systematic review

Lechien¹,

Mouawad²,

Barillari³

et al. 2019

WJCC

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BACKGROUNGFor a long time, laryngopharyngeal reflux disease (LPRD) has been treated by proton pump inhibitors (PPIs) with an uncertain success rate.AIMTo shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODSThree authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD. Clinical prospective or retrospective studies had to explore the impact of medical treatment(s) on the clinical presentation of suspected or confirmed LPRD. The criteria for considering studies for the review were based on the population, intervention, comparison, and outcome framework.RESULTSThe search identified 1355 relevant papers, of which 76 studies met the inclusion criteria, accounting for 6457 patients. A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring (MII-pH). The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk. The most used PPIs were omeprazole, esomeprazole, rabeprazole, lansoprazole and pantoprazole with a success rate ranging from 18% to 87%. Other composite treatments have been prescribed including PPIs, alginate, prokinetics, and H2 Receptor antagonists.CONCLUSIONRegarding the development of MII-pH and the identification of LPRD subtypes (acid, nonacid, mixed), future studies are needed to improve the LPRD treatment considering all subtypes of reflux.

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Do laryngoscopic findings reflect the characteristics of reflux in patients with laryngopharyngeal reflux?

Cited by 24 publications

References 21 publications

Management of Laryngopharyngeal Reflux in Asia

Management of Laryngopharyngeal Reflux in Asia

The management of suspected or confirmed laryngopharyngeal reflux patients with recalcitrant symptoms: A contemporary review

Treatment of laryngopharyngeal reflux disease: A systematic review

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