Laryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018

@article{Lechien2018LaryngopharyngealRD,
  title={Laryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018},
  author={J{\'e}r{\^o}me Ren{\'e} Lechien and Sven Saussez and Petros D. Karkos},
  journal={Current Opinion in Otolaryngology \& Head and Neck Surgery},
  year={2018},
  volume={26},
  pages={392–402}
}
Purpose of review To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux. Recent findings Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association… Expand
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References

SHOWING 1-10 OF 98 REFERENCES
Laryngopharyngeal reflux: current concepts and questions
TLDR
Treatment with proton pump inhibitors persists despite weak evidence supporting or refuting their utility, and well designed studies are needed to understand diagnosis, treatment, pathyophysiology, and long-term health consequences of laryngopharyngeal reflux and its treatment. Expand
Evaluation and management of laryngopharyngeal reflux.
TLDR
Laryngopharyngeal reflux should be suspected when the history and laryngoscopy findings are suggestive of the diagnosis and the addition of multichannel intraluminal impedance technology improves diagnostic accuracy for describing LPR events. Expand
Low-Acid Diet for Recalcitrant Laryngopharyngeal Reflux: Therapeutic Benefits and Their Implications
  • J. Koufman
  • Medicine
  • The Annals of otology, rhinology, and laryngology
  • 2011
TLDR
A strict low-acid diet appears to have beneficial effects on the symptoms and findings of recalcitrant (PPI-resistant) LPR, and further study is needed to assess the optimal duration of dietary acid restriction. Expand
Is Pepsin a Reliable Marker of Laryngopharyngeal Reflux? A Systematic Review
TLDR
Pepsin might be a reliable marker in LPR patients, although questions remain about optimal timing, location, nature, and threshold values for pepsin testing. Expand
The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers.
TLDR
The traditional attribution of hypopharynx irritation signs to reflux is challenged; the need for improved diagnostic specificity is highlighted. Expand
Effect of Antisecretory Therapy on Atypical Symptoms in Gastroesophageal Reflux Disease
TLDR
It is concluded that atypical symptoms are frequent in patients with GERD and a trial of PPI therapy should be considered prior to referring these patients to specialists. Expand
Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease
TLDR
Despite the some constraints of an observational study, rabeprazole appeared to improve LPRD symptoms and signs and prolonged medication at least 3 months may be beneficial to L PRD patients. Expand
Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study
TLDR
Age appears to reduce the subjective LPR symptom perception, leading to a lower rate of uncured patients and the utilization of acoustic parameters as an indicator of treatment effectiveness seems less useful for elderly subjects. Expand
Diagnosis of Laryngopharyngeal Reflux Disease with Digital Imaging
TLDR
Objective improvement of signs of LPRD can be detected after 6 weeks of PPI therapy using digital LVS and the Laryngopharyngeal Reflux Disease Index is a useful valid clinical tool for following treatment response to PPI Therapy. Expand
Laryngopharyngeal Reflux and Voice Disorders: A Multifactorial Model of Etiology and Pathophysiology.
TLDR
Future clinical studies examining the pathophysiology of hoarseness related to LPRD should take into consideration all potential mechanisms involved in the development of hoARSeness. Expand
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