Jerome R Lechien1,2,3,4, Lee M Akst5, Abdul Latif Hamdan1,6, Antonio Schindler1,7, Petros D Karkos1,8, Maria Rosaria Barillari1,9, Christian Calvo-Henriquez1,10, Lise Crevier-Buchman1,11, Camille Finck1,2,12, Young-Gyu Eun1,13, Sven Saussez1,2,4, Michael F Vaezi14. 1. 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France. 2. 2 Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium. 3. 3 Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons, Mons, Belgium. 4. 4 Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium. 5. 5 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 6. 6 Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon. 7. 7 Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy. 8. 8 Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece. 9. 9 Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy. 10. 10 Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain. 11. 11 Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris, France. 12. 12 Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine, University of Liège, Liège, Belgium. 13. 13 Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. 14. 14 Division of Gastroenterology, Hepatology, Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Abstract
OBJECTIVE: To review the current literature about the epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux (LPR). DATA SOURCES: PubMed, Cochrane Library, and Scopus. METHODS: A comprehensive review of the literature on LPR epidemiology, clinical presentation, diagnosis, and treatment was conducted. Using the PRISMA statement, 3 authors selected relevant publications to provide a critical analysis of the literature. CONCLUSIONS: The important heterogeneity across studies in LPR diagnosis continues to make it difficult to summarize a single body of thought. Controversies persist concerning epidemiology, clinical presentation, diagnosis, and treatment. No recent epidemiologic study exists regarding prevalence and incidence with the use of objective diagnostic tools. There is no survey that evaluates the prevalence of symptoms and signs on a large number of patients with confirmed LPR. Regarding diagnosis, an increasing number of authors used multichannel intraluminal impedance-pH monitoring, although there is no consensus regarding standardization of the diagnostic criteria. The efficiency of proton pump inhibitor (PPI) therapy remains poorly demonstrated and misevaluated by incomplete clinical tools that do not take into consideration many symptoms and extralaryngeal findings. Despite the recent advances in knowledge about nonacid LPR, treatment protocols based on PPIs do not seem to have evolved. IMPLICATIONS FOR PRACTICE: The development of multichannel intraluminal impedance-pH monitoring and pepsin and bile salt detection should be considered for the establishment of a multiparameter diagnostic approach. LPR treatment should evolve to a more personalized regimen, including diet, PPIs, alginate, and magaldrate according to individual patient characteristics. Multicenter international studies with a standardized protocol could improve scientific knowledge about LPR.
OBJECTIVE: To review the current literature about the epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux (LPR). DATA SOURCES: PubMed, Cochrane Library, and Scopus. METHODS: A comprehensive review of the literature on LPR epidemiology, clinical presentation, diagnosis, and treatment was conducted. Using the PRISMA statement, 3 authors selected relevant publications to provide a critical analysis of the literature. CONCLUSIONS: The important heterogeneity across studies in LPR diagnosis continues to make it difficult to summarize a single body of thought. Controversies persist concerning epidemiology, clinical presentation, diagnosis, and treatment. No recent epidemiologic study exists regarding prevalence and incidence with the use of objective diagnostic tools. There is no survey that evaluates the prevalence of symptoms and signs on a large number of patients with confirmed LPR. Regarding diagnosis, an increasing number of authors used multichannel intraluminal impedance-pH monitoring, although there is no consensus regarding standardization of the diagnostic criteria. The efficiency of proton pump inhibitor (PPI) therapy remains poorly demonstrated and misevaluated by incomplete clinical tools that do not take into consideration many symptoms and extralaryngeal findings. Despite the recent advances in knowledge about nonacid LPR, treatment protocols based on PPIs do not seem to have evolved. IMPLICATIONS FOR PRACTICE: The development of multichannel intraluminal impedance-pH monitoring and pepsin and bile salt detection should be considered for the establishment of a multiparameter diagnostic approach. LPR treatment should evolve to a more personalized regimen, including diet, PPIs, alginate, and magaldrate according to individual patient characteristics. Multicenter international studies with a standardized protocol could improve scientific knowledge about LPR.
Authors: Jerome R Lechien; Francois Bobin; Francois Mouawad; Karol Zelenik; Christian Calvo-Henriquez; Carlos M Chiesa-Estomba; Necati Enver; Andrea Nacci; Maria Rosaria Barillari; Antonio Schindler; Lise Crevier-Buchman; Stéphane Hans; Virginie Simeone; Elzbieta Wlodarczyk; Bernard Harmegnies; Marc Remacle; Alexandra Rodriguez; Didier Dequanter; Pierre Eisendrath; Giovanni Dapri; Camille Finck; Petros Karkos; Hillevi Pendleton; Tareck Ayad; Vinciane Muls; Sven Saussez Journal: Eur Arch Otorhinolaryngol Date: 2019-09-12 Impact factor: 2.503
Authors: Lee M Akst; Jonathan M Bock; Jerome R Lechien; Thomas L Carroll; Jacqueline E Allen; Tareck Ayad; Necati Enver; Young-Gyu Eun; Paulo S Perazzo; Fabio Pupo Ceccon; Geraldo D Sant'Anna; Rui Imamura; Sampath Kumar Raghunandhan; Carlos M Chiesa-Estomba; Christian Calvo-Henriquez; Sven Saussez; Petros D Karkos; Marc Remacle Journal: Eur Arch Otorhinolaryngol Date: 2021-02-27 Impact factor: 2.503
Authors: Jerome R Lechien; Anaïs Rameau; Lisa G De Marrez; Gautier Le Bosse; Karina Negro; Andra Sebestyen; Robin Baudouin; Sven Saussez; Stéphane Hans Journal: Eur Arch Otorhinolaryngol Date: 2022-06-28 Impact factor: 2.503
Authors: Jerome R Lechien; Stéphane Hans; Francois Bobin; Christian Calvo-Henriquez; Sven Saussez; Petros D Karkos Journal: J Clin Med Date: 2021-05-31 Impact factor: 4.241