Review of management of laryngopharyngeal reflux disease - 28/11/20

Doi : 10.1016/j.anorl.2020.11.002

J.R. Lechien ^a,^b,^c,^d,⁎, ^{^{1
These authors have equally contributed to the publication and are proposed as co-first authors.}} , F. Mouawad ^d,^{^{1
These authors have equally contributed to the publication and are proposed as co-first authors.}}, F. Bobin ^a,^e, E. Bartaire ^a,^f, L. Crevier-Buchman ^a,^g, S. Saussez ^a,^b
^a Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
^b Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
^c Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium
^d Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Lille, Hôpital Claude Huriez, Lille, France
^e Department of Otolaryngology-Head and Neck Surgery, Polyclinique de Poitiers, Poitiers, France
^f Department of Otorhinolaryngology and Head and Neck Surgery, GHICL Saint-Vincent-de-Paul Hospital, Faculté Libre de Médecine de Lille, Lille, France
^g Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris, France

^⁎Corresponding author. Laboratory of Anatomy and Cell Biology, Faculty of Medicine, University of Mons (UMONS), Avenue du Champ de Mars, 6, 7000 Mons, Belgium.Laboratory of Anatomy and Cell Biology, Faculty of Medicine, University of Mons (UMONS)Avenue du Champ de Mars, 6Mons7000Belgium

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Abstract

This review was conducted according to the Patient/problem Intervention Comparison Outcome (PICO) Statements. Some studies reported that 10–30% of patients consulting in ENT come with presenting symptoms of laryngopharyngeal reflux (LPR), but the exact prevalence of LPR is still unknown. Management has not changed in 20 years despite a significant increase in the number of publications on epidemiology, clinical presentation, diagnosis and treatment. The development of hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring (HEMII-pH) and saliva pepsin detection now allow a new multidimensional diagnostic approach associating clinical scores to HEMII-pH and saliva pepsin detection. This new approach may enable personalized treatment according to LPR profile on HEMII-pH (acid, non-acid, mixed; upright, recumbent reflux episodes). Updated treatment of LPR could consist in a 3-month association of dietary measures, proton pump inhibitors, alginate and magaldrate, followed by treatment adaptation.

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Keywords : Laryngopharyngeal, Reflux, Laryngitis, Diagnosis, Treatment