Jerome R Lechien1,2,3,4, Francois Mouawad5, Geoffrey Mortuaire5, Marc Remacle6, Francois Bobin1,7, Kathy Huet1,3, Andrea Nacci1,8, Maria Rosaria Barillari1,9, Lise Crevier-Buchman1,10, Stéphane Hans10, Camille Finck1,11, Lee M Akst1,12, Petros D Karkos1,13. 1. Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS). 2. Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium. 3. Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons, Mons, Belgium. 4. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. 5. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Lille, Université de Lille, Lille, France. 6. Department of Otorhinolaryngology and Head and Neck Surgery, CH Luxembourg, Lille, Luxembourg. 7. Department of Otorhinolaryngology and Head and Neck Surgery, Polyclinique de Poitiers, Poitiers, France. 8. ENT Audiology and Phoniatric Unit, University of Pisa, Pisa, Italy. 9. Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, Naples, Italy. 10. Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris, France. 11. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Liège, Belgium. 12. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 13. Department of Otolaryngology-Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece.
Abstract
OBJECTIVES: To investigate the current trends in management of laryngopharyngeal reflux (LPR) among young European otolaryngologists and general practitioners (GP). METHODS: An international survey was sent to European general practitioners and all otolaryngologists under 45 years old from the 2017 IFOS meeting. This survey was conducted by the LPR Study Group of YO-IFOS (Young Otolaryngologists of the International Federation of Otolaryngological Societies). RESULTS: Among the 2500 attendees, 230 European otolaryngologists (response rate = 9%) completed the survey; an additional 70 GPs also completed the survey. GPs did not differentiate between gastroeosophageal reflux disease (GERD) and LPR, overstating GERD-related symptoms (ie, heartburn and regurgitations) in LPR clinical presentation and relying on gastrointestinal endoscopy for LPR diagnosis. Otolaryngologists also believe that GERD-related symptoms are prevalent in LPR. Knowledge of nonacid and mixed LPR and use of multichannel intraluminal impedance-pH monitoring are still limited in both groups. A therapeutic dichotomy exists between groups: GPs mainly use a 4-week once daily empiric proton pump inhibitors (PPIs) trial, while otolaryngologists use PPIs twice daily for a longer therapeutic period ranging from 8 to 12 weeks. More than 50% of GPs and otolaryngologists believe that they are not adequately knowledgeable and skilled about LPR. CONCLUSION: The majority of GPs and otolaryngologists do not believe themselves to be sufficiently informed about LPR, leading to different practice patterns and grey areas. The elaboration of international recommendations in the management of reflux is needed to improve practices.
OBJECTIVES: To investigate the current trends in management of laryngopharyngeal reflux (LPR) among young European otolaryngologists and general practitioners (GP). METHODS: An international survey was sent to European general practitioners and all otolaryngologists under 45 years old from the 2017 IFOS meeting. This survey was conducted by the LPR Study Group of YO-IFOS (Young Otolaryngologists of the International Federation of Otolaryngological Societies). RESULTS: Among the 2500 attendees, 230 European otolaryngologists (response rate = 9%) completed the survey; an additional 70 GPs also completed the survey. GPs did not differentiate between gastroeosophageal reflux disease (GERD) and LPR, overstating GERD-related symptoms (ie, heartburn and regurgitations) in LPR clinical presentation and relying on gastrointestinal endoscopy for LPR diagnosis. Otolaryngologists also believe that GERD-related symptoms are prevalent in LPR. Knowledge of nonacid and mixed LPR and use of multichannel intraluminal impedance-pH monitoring are still limited in both groups. A therapeutic dichotomy exists between groups: GPs mainly use a 4-week once daily empiric proton pump inhibitors (PPIs) trial, while otolaryngologists use PPIs twice daily for a longer therapeutic period ranging from 8 to 12 weeks. More than 50% of GPs and otolaryngologists believe that they are not adequately knowledgeable and skilled about LPR. CONCLUSION: The majority of GPs and otolaryngologists do not believe themselves to be sufficiently informed about LPR, leading to different practice patterns and grey areas. The elaboration of international recommendations in the management of reflux is needed to improve practices.
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: Jerome R Lechien; Sven Saussez; Vinciane Muls; Maria R Barillari; Carlos M Chiesa-Estomba; Stéphane Hans; Petros D Karkos Journal: J Clin Med Date: 2020-11-10 Impact factor: 4.241