Do Laryngologists and General Otolaryngologists Manage Laryngopharyngeal Reflux Differently?

Jerome R. Lechien, Jacqueline Allen, Francois Mouawad, Tareck Ayad, Maria Rosaria Barillari, Kathy Huet, Lise Crevier-Buchman, Stéphane Hans, Petros D. Karkos, Young Gyu Eun, Francois Bobin, Sven Saussez, Lee M. Akst

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate current practices of laryngologists and non-laryngologists in management of Laryngopharyngeal Reflux (LPR). Methods: An online survey was sent to members of otolaryngology societies about LPR, and subgroup analysis was performed between laryngologists and non-laryngologists. This survey was conducted by the LPR Study Group of Young Otolaryngologists of the International Federation of Otolaryngological Societies. Results: A total of 535 otolaryngologists completed the survey. Among them, 127 were laryngologists and 408 were non-laryngologists. Collectively, symptoms most commonly attributed to LPR are cough after lying down/meal, throat clearing, and acid brash; most common findings are thought to be arytenoid erythema and posterior commissure hypertrophy. Respectively, 12.5% and 5% of non-laryngologists and laryngologists believe that ≥50% of LPR patients suffer from heartburn (P =.010). Non-laryngologists are more aware about some extra-laryngeal findings associated with LPR (eg, pharyngeal erythema) than laryngologists. Neither laryngologists nor non-laryngologists associated development of benign lesions of the vocal folds with reflux. The management of LPR substantially differs between groups, with laryngologists indicating increased awareness of (impedance)-pH monitoring as well as the prevalence and treatment of nonacid/mixed LPR. Conversely, non-laryngologists are much more likely to include gastroenterology referral in their management of presumed LPR. Respectively, 44.8% and 27.6% of non-laryngologists and laryngologists believe themselves not sufficiently knowledgeable about LPR. Conclusions: Significant differences exist between laryngologists and non-laryngologists in diagnosis and treatment of LPR. Overall only one-third of responders believe themselves to be sufficiently educated about LPR. Level of Evidence: 4 Laryngoscope, 130:E539–E547, 2020.

Original languageEnglish (US)
Pages (from-to)E539-E547
JournalLaryngoscope
Volume130
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • Laryngopharyngeal
  • laryngologist
  • management
  • reflux
  • survey
  • treatment

ASJC Scopus subject areas

  • Otorhinolaryngology

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