Laryngopharyngeal Reflux: Effect of Antireflux PPI Therapy on Nasal Congestion and Olfaction.

Objective: Laryngopharyngeal reflux (LPR) is responsible for many otorhinolaryngology manifestations. There is little evidence regarding the LPR impact on olfaction. No other study has investigated the efficacy of proton pump inhibitors (PPIs) on olfaction. We aimed to evaluate the effect of antireflux medication on olfaction and nasal patency in patients with LPR.

Materials and methods: Thirty patients with LPR were recruited. Nasal symptoms were self-evaluated with NOSE and SNOT-22 surveys, while a taste visual analogue scale (VAS) was used for gustation. Olfaction was evaluated with Sniffin' Sticks test and nasal patency with anterior rhinomanometry. After 12 weeks of oral PPIs, the procedure was re-applied and clinical outcomes were compared.

Results: Variables with statistically significant difference included the olfactory threshold (means 1,87/ SD 3,3/ t -3,11/ p 0,004) and the combined threshold-discrimination-identification (TDI) scores of Sniffin' Sticks test (means -2,61/ SD 5.26/ t -2.75/ p 0.01) and the self-assessment NOSE (p 0.009) and SNOT-22 (0.031) tests. However, no variable concerning nasal patency revealed statistically significant difference before and after treatment in the study group (p 0.677).

Conclusions: Oral PPIs treatment was associated with better olfactory threshold and TDI scores. These results raise the need for further studies, regarding the effect of antireflux medication on patients suffering from LPR who express nasal symptoms and olfaction disfunction.