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Updated: Aug 9, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?
Valentinos Sofokleous1, Anna-Maria Papadopoulou1, Evangelos Giotakis2
1Department of Pediatric Otorhinolaryngology, Athens Children's Hospital "P. & A. Kyriakou", 115 27 Athens, Greece.
Insights
Pediatric laryngopharyngeal reflux (LPR) research is increasing but lacks strength. Current evidence supports a step-wise approach to diagnosis and treatment, from behavioral changes to pharmacotherapy and surgery for severe cases. Further high-quality studies are needed.
Area of Science:
- Otolaryngology
- Pediatric Gastroenterology
- Reflux Disease
Background:
- Laryngopharyngeal reflux (LPR) knowledge is limited in pediatric populations compared to adults.
- This review focuses on recent advancements in pediatric LPR over the last decade.
- Identifies knowledge gaps and discrepancies for future research in pediatric LPR.
Purpose of the Study:
- To review recent and emerging aspects of pediatric laryngopharyngeal reflux (LPR) from the last ten years.
- To identify gaps in current knowledge regarding pediatric LPR.
- To highlight discrepancies that require urgent future research.
Main Methods:
- Conducted an electronic search of MEDLINE (January 2012–December 2021).
- Excluded non-English articles, case reports, and adult-predominant studies.
- Synthesized relevant information thematically in a narrative form.
Main Results:
- Included 86 articles: 27 reviews, 8 surveys, 51 original articles.
- Systematically mapped research on pediatric LPR from the past decade.
- Provided an updated overview and the current state-of-the-art in pediatric LPR.
Conclusions:
- Evidence supports refining diagnostic approaches and a step-wise therapeutic plan for pediatric LPR.
- Management ranges from behavioral changes to pharmacotherapy and surgical options for severe cases.
- Increasing evidence exists, but its strength is low, necessitating more robust, multicenter studies.
Background:
Laryngopharyngeal reflux may affect people of any age; still, most of the accumulated knowledge concerns adults, and evidence regarding pediatric populations remains relatively restricted. This study aims to review the most recent and emerging aspects of pediatric laryngopharyngeal reflux from the last ten years. It also attempts to identify gaps in knowledge and highlight discrepancies that future research should urgently address.
Methods:
An electronic search of the MEDLINE database was conducted, limited to January 2012 through December 2021. Non-English language articles, case reports, and studies that concerned a purely or predominantly adult population were excluded. The information from the articles with the most relevant contribution was initially categorized by theme and subsequently synthesized into a narrative form.
Results:
86 articles were included, of which 27 were review articles, eight were surveys, and 51 were original articles. Our review systematically maps the research done in the last decade and provides an updated overview and the current state-of-the-art in this subject.
Conclusions:
Despite discrepancies and heterogeneity in accumulating research, evidence gathered so far endorses a need for refining an escalating multiparameter diagnostic approach. A step-wise therapeutic plan appears to be the most reasonable management approach, starting with behavioral changes for mild to moderate, uncomplicated cases and escalating to personalized pharmacotherapy options for severe or nonresponsive cases. Surgical options could be considered in the most severe cases when potentially life-threatening symptoms persist despite maximal medical therapy. Over the past decade, the amount of available evidence has been gradually increasing; however, its strength remains low. Several aspects remain markedly under-addressed, and further adequately powered, multicenter, controlled studies with uniformity in diagnostic procedures and criteria are urgently needed.
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