. 2021 May;131(5):E1589-E1597.

doi: 10.1002/lary.29270. Epub 2020 Nov 17.

Management of Laryngopharyngeal Reflux Around the World: An International Study

Jerome R Lechien^{1

2

3

4}, Jacqueline E Allen⁵, Maria R Barillari^{1

6}, Petros D Karkos^{1

7}, Huan Jia^{1

8}, Fabio P Ceccon^{1

9}, Rui Imamura^{1

10}, Osama Metwaly^{1

11}, Carlos M Chiesa-Estomba^{1

12}, Jonathan M Bock¹³, Thomas L Carroll¹⁴, Sven Saussez^{1

2

3}, Lee M Akst^{1

15}

Affiliations

¹ Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
² Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
³ Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium.
⁴ Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France.
⁵ Department of Surgery, University of Auckland, Auckland, New Zealand.
⁶ Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy.
⁷ Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece.
⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁹ Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, Sao Paulo, Brazil.
¹⁰ Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil.
¹¹ Department of Otolaryngology-Head & Neck Surgery, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
¹² Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.
¹³ Division of Laryngology and the Professional Voice Department of Otolaryngology, Communication Science Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
¹⁴ Division of Otolaryngology, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

PMID: 33200831
DOI: 10.1002/lary.29270

Management of Laryngopharyngeal Reflux Around the World: An International Study

Jerome R Lechien et al. Laryngoscope. 2021 May.

. 2021 May;131(5):E1589-E1597.

doi: 10.1002/lary.29270. Epub 2020 Nov 17.

Authors

Affiliations

¹ Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
² Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
³ Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium.
⁴ Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France.
⁵ Department of Surgery, University of Auckland, Auckland, New Zealand.
⁶ Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy.
⁷ Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece.
⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁹ Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, Sao Paulo, Brazil.
¹⁰ Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil.
¹¹ Department of Otolaryngology-Head & Neck Surgery, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt.
¹² Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.
¹³ Division of Laryngology and the Professional Voice Department of Otolaryngology, Communication Science Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
¹⁴ Division of Otolaryngology, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

PMID: 33200831
DOI: 10.1002/lary.29270

Abstract

Objective: To investigate worldwide practices of otolaryngologists in the management of laryngopharyngeal reflux (LPR).

Methods: An online survey was sent on the management of LPR to members of many otolaryngological societies. The following aspects were evaluated: LPR definition, prevalence, clinical presentation, diagnosis, and treatment.

Results: A total of 824 otolaryngologists participated, spread over 65 countries. The symptoms most usually attributed to LPR are cough after lying down/meal, throat clearing and globus sensation while LPR-related findings are arytenoid erythema and posterior commissure hypertrophy. Irrespective to geography, otolaryngologists indicate lack of familiarity with impedance pH monitoring, which they attribute to lack of knowledge in result interpretation. The most common therapeutic regimens significantly vary between world regions, with a higher use of H2 blocker in North America and a lower use of alginate in South America. The duration of treatment also significantly varies between different regions, with West Asia/Africa and East Asia/Oceania otolaryngologists prescribing medication for a shorter period than the others. Only 21.1% of respondents are aware about the existence of nonacid LPR. Overall, only 43.2% of otolaryngologists believe themselves sufficiently knowledgeable about LPR.

Conclusions: LPR knowledge and management significantly vary across the world. International guidelines on LPR definition, diagnosis, and treatment are needed to improve knowledge and management around the world.

Level of evidence: N.A. Laryngoscope, 131:E1589-E1597, 2021.

Keywords: GERD; Laryngopharyngeal; diagnosis; gastroesophageal; laryngitis; management; reflux; survey; treatment.

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Management of Laryngopharyngeal Reflux Around the World: An International Study

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