How to Approach Laryngopharyngeal Reflux: An Otolaryngology Perspective

  title={How to Approach Laryngopharyngeal Reflux: An Otolaryngology Perspective},
  author={Vaninder K. Dhillon and Lee M. Akst},
  journal={Current Gastroenterology Reports},
In the otolaryngology practice, there is a rising concern with the current diagnosis and management of laryngopharyngeal reflux (LPR). The implication of LPR in many common head and neck symptoms, along with the rising cost of empiric therapy and no overall improvement in patient symptoms, has established a need to review what are indeed laryngopharyngeal complaints secondary to reflux and what are not. This article reviews the otolaryngologist’s approach to LPR, the various ways diagnosis is… 

Laryngopharyngeal Reflux: Current Concepts on Etiology and Pathophysiology and Its Role in Dysphagia

Dysphagia and LPR both have significant overlap with numerous disease entities, and few studies show that managing LPR-related dysphagia may improve with surgical intervention if there is no improvement with conservative management.

How to Understand and Treat Laryngopharyngeal Reflux.

Laryngopharyngeal Reflux and Atypical Gastroesophageal Reflux Disease.

Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux

In patients with objective evidence of GERD, TIF, or cTIF are safe and effective in controlling LPR symptoms as measured by normalization of RSI and improvement in patient satisfaction after TIF/cTIF.

Relationship between extralaryngeal endoscopic findings, proton pump inhibitor (PPI) response, and pH measures in suspected laryngopharyngeal reflux.

  • N. AgrawalR. Yadlapati B. Tan
  • Medicine
    Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • 2019
Endoscopic scores of laryngeal and extralaryngeAl findings did not predict PPI response or oropharyngeAL acid exposure in suspected LPR.


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This work intends to evaluate once‐daily, 40 mg omeprazole and once‐nightly, 300 mg ranitidine dosing as an alternative regimen, and use this study's cohort to evaluate empiric regimens prescribed for LPR as compared to up‐front testing with pH impedance multichannel intraluminal impedance (MII) with dual pH probes and high‐resolution manometry (HRM) for potential cost minimization.



Changing Impact of Gastroesophageal Reflux in Medical and Otolaryngology Practice

The hypothesis of this thesis is that GERD is an increasing problem affecting outpatient office visits over time, and the disease is increasingly managed with prescription pharmacotherapy.

Laryngopharyngeal Reflux: Paradigms for Evaluation, Diagnosis, and Treatment

Otolaryngologists are in broad agreement on symptoms and physical features of LPR; however, significant differences exist between laryngology and non-laryngologist on the use of adjunctive testing and treatment strategy.

Laryngopharyngeal Reflux: Position Statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery

Gastroesophageal reflux disease (GERD) is a clinical term that refers to GER that is excessive and that causes tissue damage and/or clinical symptoms (eg, heartburn).

Prevalence of Reflux in 113 Consecutive Patients with Laryngeal and Voice Disorders

  • J. KoufmanM. AminM. Panetti
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2000
LPR occurs in at least 50% of all patients at the center with laryngeal and voice disorders at presentation, and is found in patients with vocal cord neoplastic lesions and patients with muscle tension dysphonias.

The Reliability of the Reflux Finding Score Among General Otolaryngologists.

Perspectives in Laryngopharyngeal Reflux: An International Survey

This study was undertaken to discern the current attitudes and practices of a select cohort of otolaryngologists in regards to LPR.

Effect of aggressive therapy on laryngeal symptoms and voice characteristics in patients with gastroesophageal reflux.

Symptoms and endoscopic abnormalities in patients with documented GER improved significantly except for intermittent dysphonia and laryngeal mucosal redness after treatment, and acoustic abnormalities did not change significantly following therapy.

Pepsin detection in patients with laryngopharyngeal reflux before and after fundoplication

Pepsin is often found on laryngeal epithelial biopsy and in sputum of patients with pH-test-proven GERD and symptoms of LPR, and detection of pepsin improves diagnostic accuracy in patients with LPR.

Impact of pH Monitoring on Laryngopharyngeal Reflux Treatment

Treatment of LPR based on pH monitoring resulted in greater compliance, as well as greater symptom improvement, compared with empirical therapy alone among the patient population.