xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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TABLE IX-7 Evidence for reflux as a contributing factor for CRS Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Leason 681 2017 1 Meta-analysis 32 studies relating GERD and CRS, n = 255,323 Review of different pathogenic factors contributing to CRS H. pylori prevalence in CRS 31.7%; 87.5% of subjects with intranasal H. pylori had GORD. 52.4% of CRS patients have reflux. Nasopharyngeal reflux more common in persistent CRS. Anzic 679 2017 2 RCT (n = 60)

significantly in treatment group after 8 weeks of therapy ( p < 0.001). CRS

and endoscopy scores

decreased significantly in

treatment group compared to placebo.

Sinus and GERD symptoms improve after reflux

management, suggest role for reflux in

pathophysiology of CRS.

PND symptoms mitigated by reflux therapy, implicating reflux as causal factor in PND.

ReSI and RFS decreased

Reflux symptom index (ReSI), reflux finding score (RFS),

CRS score, nasal endoscopy score, and eosinophil cationic protein

nasopharynx, above the

cricopharyngeus, and 5 cm above the LES. Sinus and GERD symptoms

PND symptoms at 8 and 16 weeks

Reflux events in the

60 patients with diagnosed LPR and comorbid CRS, randomized groupsn = 33, treatment with

omeprazole 20 mg OD 8 weeks n = 27placebo

Pincus 677 2006 3 Cohort 30 refractory CRS patients tested for reflux; 60% of patients with reflux treated with PPI

Patients with chronic PND without RS or allergy; randomized to lansoprazole 30 mg BID or to placebo

(n = 75)

Vaezi 680 2010 2 RCT