[Gastroesophageal reflux disease and chronic sinusitis]

Area of Science:

• Otolaryngology and Gastroenterology
• Investigates the relationship between upper aerodigestive tract conditions and gastrointestinal disorders.

Context:

• Growing evidence suggests a potential link between gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) and chronic sinusitis.
• The etiological role of reflux in chronic sinusitis remains unclear, necessitating a review of existing literature.

Purpose:

• To systematically evaluate the scientific literature for evidence supporting the association between GERD/LPR and chronic sinusitis.
• To assess the quality and level of evidence for studies investigating this connection.

Summary:

• A literature search identified 77 references in Medline and 142 in EMBASE. Only 12 papers and one case report directly addressed the link between chronic sinusitis and reflux.
• None of the reviewed studies met the highest evidence level (Ia or Ib); ten were level III, one level IIb, and one level IV.
• While reflux into the pharynx and nasopharynx (LPR) is possible and may cause inflammation treatable with antireflux therapy, its definitive role in chronic sinusitis pathogenesis is not established.

Impact:

• Current evidence is insufficient to definitively establish GERD/LPR as a cause of chronic sinusitis.
• Further high-quality, prospective, randomized controlled trials with standardized documentation are required to clarify the etiological role, exacerbating influence, or epiphenomenal nature of LPR in chronic sinusitis.
• Despite limitations, studies indicate a potential association, suggesting that an above-average proportion of chronic rhinosinusitis patients may have GERD/LPR.