Laryngopharyngeal reflux (LPR) occurs when gastric contents (acid and enzymes such as pepsin) flow in a retrograde fashion and contact the tissues of the upper aerodigestive tract. LPR may be associated with chronic sore throat, hoarseness, frequent throat clearing, cough, globus sensation, refractory asthma, laryngeal ulcers and granulomas, subglottic stenosis, carcinoma, OSA, and sinonasal disease among other conditions. Only about 1/3 of patients suspected of having LPR experience classic gastroesophageal reflux (GERD) symptoms including heartburn and regurgitation. Diagnosis and treatment of LPR are within the scope of practice of Otolaryngology – Head & Neck Surgery. This may include endoscopy, imaging and pharyngoesophageal testing. Initial empiric treatment with medication is often the first line of treatment, as response to medication may be diagnostic. When possible, lifestyle and behavioral changes should be encouraged. Surgery to control reflux may be necessary in some patients with LPR.
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Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.