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Association between Laryngopharyngeal Reflux, Gastroesophageal Reflux and Recalcitrant Chronic Rhinosinusitis: A Systematic Review.
  • Jerome Lechien,
  • Sven Saussez,
  • Claire Hopkins
Jerome Lechien
Universite de Mons

Corresponding Author:[email protected]

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Sven Saussez
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Claire Hopkins
Guy's and St Thomas' Hospitals NHS Trust
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Objective: To investigate the association between laryngopharyngeal reflux (LPR), gastroesophageal reflux disease (GERD) and recalcitrant chronic rhinosinusitis (CRS). Data sources: PubMed, Cochrane Library, and Scopus. Review methods: Three investigators search database for studies investigating the relationship between LPR, GERD and recalcitrant CRS with or without polyposis. The following outcomes were investigated with PRISMA criteria: age; gender; reflux and CRS diagnosis; association outcomes and potential treatment outcomes. Authors performed a bias analysis of papers and provided recommendations for future studies. Results: A total of 17 studies investigated the association between reflux and recalcitrant CRS. According to pharyngeal pH monitoring, 54% of patients with recalcitrant CRS reported hypo or nasopharyngeal acid reflux events. The numbers of hypo- and nasopharyngeal acid reflux events were significantly higher in patients compared to healthy individuals in 4 and 2 studies, respectively. Only one report did not find group differences. The proportion of GERD was significantly higher in CRS patients compared to controls, with a prevalence ranging from 32% to 91% of cases. No author considered nonacid reflux events. There was an important heterogeneity in the inclusion criteria; definition of reflux and association outcomes, limiting the draw of clear conclusion. Pepsin was found in sinonasal secretions more frequently in CRS patients than controls. Conclusion: Laryngopharyngeal reflux and GERD may be a contributing factors of CRS therapeutic resistance, but future studies are still needed to confirm the association considering nonacid reflux event.
23 Oct 2022Submitted to Clinical Otolaryngology
28 Oct 2022Submission Checks Completed
28 Oct 2022Assigned to Editor
02 Nov 2022Reviewer(s) Assigned
21 Nov 2022Review(s) Completed, Editorial Evaluation Pending
27 Nov 2022Editorial Decision: Revise Major
24 Dec 20221st Revision Received
04 Jan 2023Assigned to Editor
04 Jan 2023Submission Checks Completed
15 Jan 2023Reviewer(s) Assigned
21 Jan 2023Review(s) Completed, Editorial Evaluation Pending
05 Feb 2023Editorial Decision: Revise Minor
08 Feb 20232nd Revision Received
09 Feb 2023Submission Checks Completed
09 Feb 2023Assigned to Editor
12 Feb 2023Reviewer(s) Assigned
17 Feb 2023Review(s) Completed, Editorial Evaluation Pending
19 Feb 2023Editorial Decision: Accept