Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation

Eugene Wong; Nathaniel Deboever; Niranjan Sritharan; Narinder Singh

doi:10.5152/ejra.2020.235

Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation

Abstract

Objective: Laryngopharyngeal reflux (LPR) is defined as a retrograde flow of gastric contents into the larynx and hypopharynx. However, a possible pathophysiological contribution from nasal resistance has been proposed, according to which increased nasal resistance associated with septal deviation may cause increased respiratory effort, resulting in a more negative intrathoracic pressure, which may, in turn, overcome the upper esophageal sphincter and lead to the retrograde passage of gastric contents. The aim of this study was to investigate whether septal deviation of adequate severity necessitating septoplasty is associated with an increased use of proton pump inhibitors (PPIs) in comparison with the general population. Material and Methods: This retrospective single-center cohort study investigated the usage of PPIs in patients undergoing septoplasty. Hospital databases were searched to identify patients aged 18-85 years who underwent septoplasty from January 2012 to December 2016. Electronic medical records were reviewed to collect details pertaining to demographic variables, usage of PPIs, smoking and drinking status, and other comorbidities. A control group of subjects who underwent an unrelated procedure (arthroscopy) was also sampled. Results: The data of 200 patients (29% females, mean age 40.8±14.8 years) who underwent septoplasties were compared with those of 200 control subjects (39.5% females, mean age 45.3±15.0 years) who underwent arthroscopies. The incidence of PPI usage in patients undergoing septoplasty was found to be significantly greater than that in the control group (Pearson’s chi-square 4.7, Odds Ratio [OR] 1.97, p=0.03). Conclusion: Patients who undergo septoplasty have a significantly increased rate of PPI usage, which suggests that nasal obstruction is associated with LPR and gastroesophageal reflux disease. Further studies are required to explore this association and develop potential therapeutic strategies.

Keywords

References

Siupsinskiene N, Adamonis K, Toohill RJ. Quality of life in laryngopharyngeal reflux patients. Laryngoscope 2007; 117: 480-4.
DelGaudio JM, Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope 2005; 115: 946-57.
Altman KW, Prufer N, Vaezi MF. A review of clinical practice guidelines for reflux disease: Toward creating a clinical protocol for the otolaryngologist. Laryngoscope 2011; 121: 717-23.
Salihefendic N, Zildzic M, Cabric E. Laryngopharyngeal Reflux Disease - LPRD. Med Arch 2017; 71: 215-8.
Kim SJ, Kim HY, Jeong JI, Hong SD, Chung SK, Dhong HJ. Changes in the reflux symptom index after multilevel surgery for obstructive sleep apnea. Clin Exp Otorhinolaryngol 2017; 10: 259-64.
Fraser-Kirk K. Laryngopharyngeal reflux: A confounding cause of aerodigestive dysfunction. Aust Fam Physician 2017; 46: 34-9. Joo YH, Song YS, Pae CU. Relationship between depression and laryngopharyngeal reflux. Psychiatry Investig 2017; 14: 226-9.
Gelardi M, Ciprandi G. Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): New pragmatic insights in clinical practice. J Biol Regul Homeost Agents 2018; 32: 41-7.
Wan Y, Yan Y, Ma F, Wang L, Lu P, Maytag A, et al. LPR: How different diagnostic tools shape the outcomes of treatment. J Voice 2014; 28: 362-8.

Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Eugene Wong This is me
0000-0002-5799-5083
Australia

Nathaniel Deboever This is me
0000-0001-8942-5256
Australia

Niranjan Sritharan This is me
0000-0003-4916-6610
Australia

Narinder Singh This is me
0000-0002-8794-8157
Australia

Publication Date

April 1, 2020

Submission Date

November 12, 2019

Acceptance Date

December 6, 2019

Published in Issue

Year 2020 Volume: 3 Number: 1

DOI

https://doi.org/10.5152/ejra.2020.235

IZ

https://izlik.org/JA58YY85TT

Cite

RIS / Bibtex

APA

Wong, E., Deboever, N., Sritharan, N., & Singh, N. (2020). Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation. European Journal of Rhinology and Allergy, 3(1), 1-3. https://doi.org/10.5152/ejra.2020.235

AMA

1.Wong E, Deboever N, Sritharan N, Singh N. Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation. Eur J Rhinol Allergy. 2020;3(1):1-3. doi:10.5152/ejra.2020.235

Chicago

Wong, Eugene, Nathaniel Deboever, Niranjan Sritharan, and Narinder Singh. 2020. “Laryngopharyngeal Reflux Is Associated With Nasal Septal Deviation”. European Journal of Rhinology and Allergy 3 (1): 1-3. https://doi.org/10.5152/ejra.2020.235.

EndNote

Wong E, Deboever N, Sritharan N, Singh N (April 1, 2020) Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation. European Journal of Rhinology and Allergy 3 1 1–3.

IEEE

[1]E. Wong, N. Deboever, N. Sritharan, and N. Singh, “Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation”, Eur J Rhinol Allergy, vol. 3, no. 1, pp. 1–3, Apr. 2020, doi: 10.5152/ejra.2020.235.

ISNAD

Wong, Eugene - Deboever, Nathaniel - Sritharan, Niranjan - Singh, Narinder. “Laryngopharyngeal Reflux Is Associated With Nasal Septal Deviation”. European Journal of Rhinology and Allergy 3/1 (April 1, 2020): 1-3. https://doi.org/10.5152/ejra.2020.235.

JAMA

1.Wong E, Deboever N, Sritharan N, Singh N. Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation. Eur J Rhinol Allergy. 2020;3:1–3.

MLA

Wong, Eugene, et al. “Laryngopharyngeal Reflux Is Associated With Nasal Septal Deviation”. European Journal of Rhinology and Allergy, vol. 3, no. 1, Apr. 2020, pp. 1-3, doi:10.5152/ejra.2020.235.

Vancouver

1.Eugene Wong, Nathaniel Deboever, Niranjan Sritharan, Narinder Singh. Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation. Eur J Rhinol Allergy. 2020 Apr. 1;3(1):1-3. doi:10.5152/ejra.2020.235