Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease.
OBJECTIVE
Laryngopharyngeal reflux is a well-recognized and widely used term in ear, nose and throat practice. However, the symptoms and signs attributed to laryngopharyngeal reflux are non-specific and treatment is usually empirical. This review discusses current knowledge on diagnosis and treatment of laryngopharyngeal reflux.


RESULTS
Information is evolving regarding the implications of laryngopharyngeal reflux in the development of pathological conditions affecting the upper aerodigestive tract epithelium such as chronic laryngitis, otitis media with effusion and chronic sinusitis. However, there is still much to learn about the pathophysiologic mechanisms of laryngopharyngeal reflux and their role in its related disease conditions and there is still considerable controversy on diagnostic as well as therapeutic parameters for this condition. There is no consensus on the diagnosis and treatment of laryngopharyngeal reflux and the majority of clinicians depend mainly on clinical findings and empirical therapeutic tests rather than more specific investigations.


CONCLUSIONS
The concept of laryngopharyngeal reflux is still controversial. The current practice of empirical treatment with proton-pump inhibitors is based on weak evidence. However, this practice seems to be widely accepted and will not change until further clinical and laboratory studies improve our understanding of this common and well-recognized condition.
Ali
Mahmoud El-Sayed
Mel-S
ENT Department, East Surrey Hospital, Redhill, Surrey, UK. msamomar@yahoo.co.uk
D002908:Chronic Disease; D049630:Esophageal Sphincter, Lower / Q000473:pathology; D049631:Esophageal Sphincter, Upper / Q000473:pathology; D050782:Esophageal pH Monitoring; D005247:Feeding Behavior; D005744:Gastric Acid / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007013:Hypopharynx / Q000276:immunology / Q000473:pathology*; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D007828:Laryngoscopy; D008019:Life Style; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000276:immunology / Q000473:pathology / Q000628:therapy; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors