Laryngopharyngeal reflux: current concepts and questions.
OBJECTIVE
Laryngopharyngeal reflux is a widely recognized disorder. Yet, decades after its initial description, debate persists regarding pathophysiology, diagnosis, and treatment. This review addresses current literature on laryngopharyngeal reflux and identifies areas of controversy and future opportunities for research.


RESULTS
Despite numerous research efforts, the diagnosis and treatment of laryngopharyngeal reflux remain elusive and unproven. Acid-induced changes in laryngopharyngeal mucosa have been confirmed by histologic evidence. However, the implications of this for laryngeal symptoms and signs are unclear. Diagnosis remains controversial, confounded by lack of standardization and accepted, evidence-based norms. Whereas treatment is generally believed by clinicians to be effective in alleviating symptoms and signs attributed to laryngopharyngeal reflux, incontrovertible data confirming efficacy are scarce. Confounding the issues further, there are numerous studies that purport to show that various widely used treatments are not effective, although the scientific merit of virtually all of these studies has been challenged.


CONCLUSIONS
Laryngopharyngeal reflux remains a controversial diagnosis. 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.
Gupta
Reena
R
Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania 19103, USA.
Sataloff
Robert Thayer
RT
D000818:Animals; D004195:Disease Models, Animal; D050782:Esophageal pH Monitoring; D004945:Esophagoscopy; D018662:Fundoplication; D005744:Gastric Acid / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006551:Hernia, Hiatal / Q000150:complications / Q000503:physiopathology; D006685:Hoarseness / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D007827:Laryngitis / Q000209:etiology / Q000503:physiopathology; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D054328:Proton Pump Inhibitors