Airway reflux.
An ever-increasing number of adult and pediatric disorders have been shown to be influenced or caused by airway reflux. This has become a controversial and complicated aspect of medicine that requires a multidisciplinary approach. Evidence indicates that it is not only the acidic components of gastric refluxate that injure extraesophageal tissues but also the nonacidic components, such as pepsin and bile. There is a realization that proton pump inhibitors will not be effective when nonacidic components of refluxate are causing the problem. New in vitro and in vivo models for the study of airway reflux and new therapeutic and surgical approaches are discussed in this review article.
Departments of Otolaryngology and Communication Sciences, and Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee, Wisconsin. njohnsto@mcw.edu.
Nikki
N
Johnston
Department of Otolaryngology and Masonic Cancer Center, University of Minnesota School of Medicine, Duluth, Minnesota.
Frank
F
Ondrey
Department of Gastroenterology and Nutrition, Boston's Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Rachel
R
Rosen
Department of Pediatrics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
Bryan P
BP
Hurley
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Jon
J
Gould
Department of Surgery, University of Auckland, Auckland, New Zealand.
Jacquie
J
Allen
Department of Otolaryngology, Emory University, Atlanta, Georgia.
John
J
DelGaudio
Department of Otolaryngology - Head & Neck Surgery, Baylor College of Medicine, Houston, Texas.
Kenneth W
KW
Altman
D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D050782:Esophageal pH Monitoring / Q000379:methods; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*; D007828:Laryngoscopy / Q000379:methods; D010434:Pepsin A / Q000378:metabolism; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism
D015415:Biomarkers; D054328:Proton Pump Inhibitors; D010434:Pepsin A
airway; extraesophageal reflux (EER); laryngopharyngeal reflux (LPR); pepsin; reflux; surgical approaches; therapeutic approaches