The Impact of Laryngopharyngeal Reflux on Patient-reported Measures of Chronic Rhinosinusitis

Objective: This study explored the impact of laryngopharyngeal reflux (LPR) on quality-of-life outcomes captured by Sino-Nasal Outcome Test (SNOT-22) and Reflux Symptom Index (RSI) in patients with chronic rhinosinusitis (CRS) and patients with symptoms of LPR. Methods: In a retrospective chart review, SNOT-22 and RSI scores were analyzed in patients seen at a tertiary care center with CRS, LPR, or both CRS and LPR. SNOT-22 items were grouped into sleep, nasal, otologic, and emotional symptom subdomains. Results: A total of 138 patients (36 with CRS alone, 60 with LPR alone, and 42 with both CRS and LPR) were included. Compared to patients with CRS alone, those with CRS and LPR (CRS+LPR) had higher SNOT-22 total (50.54 +/- 19.53 vs 35.31 +/- 20.20, P < .001), sleep (19.61 +/- 9.31 vs 14.42 +/- 10.34, P < .022), nasal (17.38 +/- 7.49 vs 11.11 +/- 8.52, P < .001), otologic subdomains (9.17 +/- 5.07 vs 5.53 +/- 5.14, P < .002), and RSI (22.06 +/- 9.42 vs 10.75 +/- 8.43, P < .003). Patients with LPR alone had higher RSI compared to those with CRS (18.48 +/- 9.77 vs 10.75 +/- 8.43, P < .037). RSI and SNOT-22 scores were positively correlated irrespective of patient group (R = 0.289, P = .003). Conclusion: Compared to patients with CRS or LPR alone, those with CRS+LPR demonstrated higher RSI and total and subdomain SNOT-22 scores. Patients with LPR alone had elevated SNOT-22 despite absent endoscopic evidence of sinusitis.