Management of Laryngopharyngeal Reflux in Asia Publisher



Kim SI^{1, 2} ; Lechien JR^{1, 3, 4} ; Ayad T^{1, 5} ; Jia H^{1, 6} ; Khoddami SM^{1, 7} ; Enver N^{1, 8} ; Raghunandhan SK^{1, 9} ; Hamdan AL^{1, 10} ; Eun YG^{1, 2} Show Affiliations
Source: Clinical and Experimental Otorhinolaryngology Published:2020

Abstract

Objectives. This study was conducted to investigate the current practices of Asian otolaryngologists for laryngopharyngeal reflux (LPR). Methods. An online survey about LPR was sent to 2,000 members of Asian otolaryngological societies, and a subgroup analysis was performed betweenWestern and Eastern Asian otolaryngologists. The survey was conducted by the La-ryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryn-gological Societies. Results. Among approximately 1,600 Asian otolaryngologists, 146 completed the survey (62 fromWestern Asian countries, 84 from Eastern Asian countries). A substantial majority (73.3%) of the otolaryngologists considered LPR and gas-troesophageal reflux disease to be different diseases.The symptoms thought to be closely related to LPR were coughing after lying down, throat clearing, and globus sensation. The findings thought to be closely related to LPR were posterior commissure granulations and hypertrophy, arytenoids, and laryngeal erythema. The respondents indicated that they mostly diagnosed LPR (70%) after an empirical therapeutic trial of proton pump inhibitors (PPIs). Although multichannel intraluminal impedance-pH (MII-pH) monitoring is a useful tool for diagnosing nonacid or mixed LPR, 78% of Asian otolaryngologists never or very rarely used MII-pH. Eastern Asian otolaryngologists more frequently used once-daily PPIs (64.3% vs. 45.2%, P=0.021), whereas Western Asian otolaryngologists preferred to use twice-daily PPIs (58.1% vs. 39.3%, P=0.025). The poor dietary habits of patients were considered to be the main reason for therapeutic failure by Asian otolaryngologists (53.8%). Only 48.6% of Asian otolaryngologists considered themselves to be adequately knowledgeable and skilled regarding LPR. Conclusion. Significant differences exist between Western and Eastern Asian otolaryngologists in the diagnosis and treatment of LPR. Future consensus statements are needed to establish diagnostic criteria and therapeutic regimens. © 2020 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.