May 19, 2017

Association of Oral Antireflux Medication With Laryngopharyngeal Reflux and Nasal Resistance

Question  Is laryngopharyngeal reflux associated with nasal resistance, and does pharmacologic therapy improve subjective and objective nasal findings?
Findings  This case-control study of 100 adults (50 with laryngopharyngeal reflux, 50 controls) found that oral antireflux medication was associated with significant decreases in all parameters of the Nasal Obstruction Symptom Evaluation and Total Nasal Resistance values.
Meaning  Laryngopharyngeal reflux has a negative effect on nasal resistance and nasal congestion; treatment may improve subjective and objective nasal findings.

Abstract
Importance  Laryngopharyngeal reflux (LPR) is thought to be a potential exacerbating factor in upper airway diseases.
Objective  To describe the effect of pharmacologic therapy of laryngopharyngeal reflux on nasal resistance.
Design, Setting, and Participants  Prospective observational study performed between August 30, 2014, and October 1, 2015, at a tertiary care academic center including 50 patients with Reflux Symptom Index higher than 13 and Reflux Finding Score higher than 7 and 50 controls with no history of LPR and nasal disease.
Interventions  Oral antireflux medication was given to the LPR group for 12 weeks.
Main Outcomes and Measures  The measurements of total nasal resistance (TNR) were performed by means of active anterior rhinomanometry technique and Nasal Obstruction Symptom Evaluation (NOSE) was assessed.
Results  The LPR group had 29 (58%) women and a median age of 41.5 years (range, 18-64 years). The control group had 27 (54%) women and a median age of 38.5 years (range, 19-63 years). After treatment, a significant decrease was observed in all parameters. The median (range) TNR scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median TNR score of the control group was 0.20 (range, 0.11-0.32). Whereas the TNR scores of the LPR group were higher than those of the control group before treatment (difference, −0.77; 95% CI, −0.10 to 0.05), they were almost the same after treatment (difference, 0.01; 95% CI, −0.01 to 0.03). The median (range) NOSE scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median NOSE score of the control group was 0.20 (range, 0.11-0.32).
Conclusions and Relevance  In this study, laryngopharyngeal reflux had a negative effect on nasal resistance and nasal congestion. Treatment was associated with improved subjective and objective nasal findings.

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