The Impact of Laryngopharyngeal Reflux on Occurrence and Clinical Course of Recurrent Respiratory Papillomatosis

Laryngoscope. 2022 Mar;132(3):619-625. doi: 10.1002/lary.29793. Epub 2021 Aug 2.

Abstract

Objectives/hypothesis: Laryngopharyngeal reflux (LPR) has been proposed both as a trigger for recurrent respiratory papillomatosis (RRP) onset and as a factor favoring an aggressive clinical course.

Study design: In this prospective study, 106 participants were recruited within a period of 24 months at the Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana.

Methods: This study compared a group of RRP patients (N = 36) with a group of LPR patients (N = 28) and a group of healthy participants (N = 42) based on Reflux Symptom Index (RSI), Reflux Finding Scores (RFS), and saliva analyses (pH, pepsin concentration, bile acid concentration, and pepsin enzymatic activity).

Results: The RRP group compared to the LPR group showed a statistically significant difference only in RSI and RFS scores, while the RRP group compared to healthy controls showed significantly higher values in all tested parameters (RSI score, RFS, saliva pH, pepsin concentration, bile acids concentration, pepsin enzymatic activity).

Conclusions: LPR is common in RRP patients and significantly more prevalent compared to healthy controls. Our results show that saliva analyses are a better office-based tool than RSI questionnaires and RFS scores for diagnosing LPR in RRP patients.

Level of evidence: 3 Laryngoscope, 132:619-625, 2022.

Keywords: Recurrent respiratory papillomatosis; laryngopharyngeal reflux; pepsin; saliva.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Case-Control Studies
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Laryngopharyngeal Reflux / complications*
  • Laryngopharyngeal Reflux / diagnosis
  • Male
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / etiology*
  • Papillomavirus Infections / pathology
  • Prospective Studies
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / etiology*
  • Respiratory Tract Infections / pathology
  • Risk Factors
  • Saliva / chemistry

Supplementary concepts

  • Recurrent respiratory papillomatosis