Background: This study aimed to explore the characteristics of laryngopharyngeal reflux (LPR) and the association between LPR and allergic rhinitis (AR). Methods: In this prospective case-control study, a total of 102 patients with suspected LPR who visited the Department of Otolaryngology Head and Neck Surgery, Heping Hospital Affiliated to Changzhi Medical College, between June 2019 and June 2021 were consecutively included. They were divided into the LPR-positive group and the LPR-negative group according to 24-h Dx-pH monitoring. The influencing factors of LPR, including the scores for AR (SFAR) and AR prevalence, were compared between the two groups. Results: The total SFAR and scores in items 1, 3, 4, and 5 of the LPR-positive group were significantly higher than those of the LPR-negative group (p < 0.05). The prevalence of AR in the LPR-positive group was 60%, which was significantly higher than that in the LPR-negative group (36.54%) (p < 0.05). After excluding confounding factors, AR was positively correlated with the incidence of LPR, and the incidence of LPR with AR was 2.372 times that of non-AR. Receiver operating characteristic curve results show that AR has the highest predictive value for LPR, and the area of AR under the curve is was 0.617. Conclusions: The SFAR and incidence of AR are high in patients with positive LPR, and AR may be a risk factor for LPR. The results of this study may deepen our understanding of the occurrence of LPR.

Keywords:
Laryngopharyngeal reflux, Allergic rhinitis, Dx-pH monitoring, Score for allergic rhinitis, Clinical correlation
1.
Galluzzi F, Schindler A, Gaini RM, Garavello W. The assessment of children with suspected laryngopharyngeal reflux: an otorhinolaringological persepective.
Int J Pediatr Otorhinolaryngol
. 2015;79(10):1613–9.
2.
Yang J, Dehom S, Sanders S, Murry T, Krishna P, Crawley BK. Treating laryngopharyngeal reflux: evaluation of an anti-reflux program with comparison to medications.
Am J Otolaryngol
. 2018;39(1):50–5.
3.
Ford CN. Evaluation and management of laryngopharyngeal reflux.
JAMA
. 2005;294(12):1534–40.
4.
Kelly EA, Samuels TL, Johnston N. Chronic pepsin exposure promotes anchorage-independent growth and migration of a hypopharyngeal squamous cell line.
Otolaryngol Head Neck Surg
. 2014;150(4):618–24.
5.
Johnston N, Knight J, Dettmar PW, Lively MO, Koufman J. Pepsin and carbonic anhydrase isoenzyme III as diagnostic markers for laryngopharyngeal reflux disease.
Laryngoscope
. 2004;114(12):2129–34.
6.
Ayazi S, Lipham JC, Hagen JA, Tang AL, Zehetner J, Leers JM, et al. A new technique for measurement of pharyngeal pH: normal values and discriminating pH threshold.
J Gastrointest Surg
. 2009;13(8):1422–9.
7.
Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA. Laryngopharyngeal reflux and voice disorders: a multifactorial model of etiology and pathophysiology.
J Voice
. 2017;31(6):733–52.
8.
Hamdan AL, Jaffal H, Btaiche R, Turfe ZA, Bawab I, Kanj N, et al. Laryngopharyngeal symptoms in patients with asthma: a cross-sectional controlled study.
Clin Respir J
. 2016;10(1):40–7.
9.
Eren E, Arslanoğlu S, Aktaş A, Kopar A, Ciğer E, Önal K, et al. Factors confusing the diagnosis of laryngopharyngeal reflux: the role of allergic rhinitis and inter-rater variability of laryngeal findings.
Eur Arch Otorhinolaryngol
. 2014;271(4):743–7.
10.
Dykewicz MS, Fineman S. Executive summary of joint task force practice parameters on diagnosis and management of rhinitis.
Ann Allergy Asthma Immunol
. 1998;81(5):463–8.
11.
Pawankar R, Canonica GW, Holgate ST, Lockey RF. Allergic diseases and asthma: a major global health concern.
Curr Opin Allergy Clin Immunol
. 2012;12(1):39–41.
12.
Turley R, Cohen SM, Becker A, Ebert CS. Role of rhinitis in laryngitis: another dimension of the unified airway.
Ann Otol Rhinol Laryngol
. 2011;120(8):505–10.
13.
Wu Y, Liang F. Clinical pilot study on the rhinitis due to laryngopharyngeal reflux.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
. 2016;30(3):200–2. (in Chinese).
14.
Alharethy S, Baqays A, Mesallam TA, Syouri F, Wedami MA, Aldrees T, et al. Correlation between allergic rhinitis and laryngopharyngeal reflux.
Biomed Res Int
. 2018;2018(9):2951928.
15.
Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies.
Allergy
. 2015;57(2):107–14.
16.
Lam SC, Yeung CCY, Chan JHM, Lam DWC, Lam AHY, Annesi-Maesano I, et al. Adaptation of the score for allergic rhinitis in the Chinese population: psychometric properties and diagnostic accuracy.
Int Arch Allergy Imm
. 2017;173(4):213–24.
17.
Piau JP, Massot C, Moreau D, Ait-Khaled N, Bouayad Z, Mohammad Y, et al. Assessing allergic rhinitis in developing countries.
Int J Tuberc Lung Dis
. 2010;14(4):506–12.
18.
Randhawa PS, Mansuri S, Rubin JS. Is dysphonia due to allergic laryngitis being misdiagnosed as laryngopharyngeal reflux?
Logoped Phoniatr Vocol
. 2010;35(1):1–5.
19.
Pacheco-Galvan A, Hart SP, Morice AH. Relationship between gastro-oesophageal reflux and airway diseases: the airway reflux paradigm.
Arch Bronconeumol
. 2011;47(4):195–203.
20.
Loehrl TA, Smith TL. Chronic sinusitis and gastroesophageal reflux: are they related?
Curr Opin Otolaryngol Head Neck Surg
. 2004;12(1):18–20.
21.
Stein MR. Possible mechanisms of influence of esophageal acid on airway hyperresponsiveness.
Am J Med
. 2003;115 Suppl 3A:55S–9S.
22.
Mori S, Pawankar R, Ozu C, Nonaka M, Yagi T, Okubo K. Expression and roles of MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2 in allergic nasal mucosa.
Allergy Asthma Immunol Res
. 2012;4(4):231–9.
23.
Cheng CM, Hsieh CC, Lin CS, Dai ZK, Shih PK, Everett ML, et al. Macrophage activation by gastric fluid suggests MMP involvement in aspiration-induced lung disease.
Immunobiology
. 2010;215(3):173–81.
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