Ahmad Aldajani, Fahad Alhussain, Tamer Mesallam, Mashal AbaAlkhail, Raed Alojayri, Hashem Bassam, Omar Alotaibi, Mohammed Alqahtani, Saad Alsaleh
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引用次数: 0
Abstract
Background: Over the last few decades, reflux diseases, such as laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD), have been identified as significant contributors to inflammatory upper aerodigestive tract diseases. Establishing a direct relationship between reflux disease and chronic rhinosinusitis (CRS) is challenging due to the high prevalence of both diseases and their potential for independent coexistence.
Objective: The purpose of this study is to review the existing literature and evaluate the evidence of an association between reflux diseases and CRS.
Methods: A comprehensive electronic search was conducted across multiple databases to identify all studies that investigated the relationship between LPR, GERD, and CRS from January 1, 1950, to June 16, 2022. Only studies with English manuscripts involving adult populations were included, while case series, case reports, and in vitro studies were excluded. The risk of bias was evaluated using The Newcastle-Ottawa Scale for case-control studies and the NIH quality assessment tool for observational cohort and cross-sectional studies.
Results: The search strategy yielded a total of 427 articles, out of which 25 studies examined the correlation between reflux diseases and CRS. The meta-analysis indicated a significant association between the presence of GERD and CRS compared to control groups (P < .001; CI 3.56 [2.25, 5.65]), as well as significantly higher pH values and pepsin detection in CRS patients when compared to healthy individuals (P = .003). Furthermore, all studies that evaluated proton pump inhibitor (PPI) therapy in CRS patients reported positive outcomes, with 93% of CRS patients showing improvement on PPIs.
Conclusion: The existing literature provides suggestive evidence of an association between reflux diseases and CRS, with regards to both prevalence and treatment. Nonetheless, further studies are required to confirm this relationship.
背景：在过去的几十年里，反流性疾病，如咽喉反流（LPR）和胃食管反流病（GERD），已被确定为炎症性上消化道疾病的重要诱因。建立反流性疾病和慢性鼻窦炎（CRS）之间的直接关系是具有挑战性的，因为这两种疾病的患病率很高，并且它们有可能独立共存。目的：本研究的目的是回顾现有文献，评估反流性疾病与CRS之间关联的证据。方法：在多个数据库中进行全面的电子搜索，以确定1950年1月1日至2022年6月16日期间调查LPR、GERD和CRS之间关系的所有研究。只包括涉及成年人群的英文手稿研究，而排除了病例系列、病例报告和体外研究。使用Newcastle Ottawa量表进行病例对照研究，使用NIH质量评估工具进行观察性队列和横断面研究，评估偏倚风险。结果：该搜索策略共产生427篇文章，其中25项研究考察了反流性疾病与CRS之间的相关性。荟萃分析表明，与对照组相比，GERD和CRS的存在之间存在显著相关性（P P = .003）。此外，所有评估CRS患者质子泵抑制剂（PPI）治疗的研究都报告了积极的结果，93%的CRS患者PPI有所改善。结论：现有文献提供了反流性疾病与CRS之间存在相关性的提示性证据，包括患病率和治疗。尽管如此，还需要进一步的研究来证实这种关系。
期刊介绍：
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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