Laryngopharyngeal Reflux: Historical Perspectives, Current Diagnostics and Therapies, and Remaining Challenges

The concept of laryngopharyngeal reflux has evolved since it was first used to describe the retrograde flow of gastric contents into the upper airway leading to upper airway symptoms. Decades of cross-disciplinary research have led to our current understanding of this process, which emphasizes differentiating laryngopharyngeal reflux disease (characterized by symptoms with objective evidence of reflux) from laryngopharyngeal symptoms (which can occur with or without pathological reflux). It is essential to recognize this distinction for effective management because laryngopharyngeal reflux disease may respond to anti-reflux therapy, whereas the management of laryngopharyngeal symptoms depends on the clinical entity or entities contributing to them. This review summarizes the historical development of the laryngopharyngeal reflux concept, outlines current diagnostic and therapeutic approaches for laryngopharyngeal reflux disease, and highlights ongoing challenges and opportunities for future research. We conclude that continued interdisciplinary collaboration is essential for improving both evidence-based diagnoses and effective treatment outcomes.