Sofokleous Valentinos, Papadopoulou Anna-Maria, Giotakis Evangelos, Delides Alexander, Kyrodimos Efthymios, Maragoudakis Pavlos, Psarommatis Ioannis
Department of Pediatric Otorhinolaryngology, Athens Children's Hospital "P. & A. Kyriakou", 115 27 Athens, Greece.
1st Department of Otorhinolaryngology-Head & Neck Surgery, University of Athens, 'Hippocration' General Hospital, 115 27 Athens, Greece.
J Clin Med. 2023 Feb 10;12(4):1436. doi: 10.3390/jcm12041436.
Laryngopharyngeal reflux may affect people of any age; still, most of the accumulated knowledge concerns adults, and evidence regarding pediatric populations remains relatively restricted. This study aims to review the most recent and emerging aspects of pediatric laryngopharyngeal reflux from the last ten years. It also attempts to identify gaps in knowledge and highlight discrepancies that future research should urgently address.
An electronic search of the MEDLINE database was conducted, limited to January 2012 through December 2021. Non-English language articles, case reports, and studies that concerned a purely or predominantly adult population were excluded. The information from the articles with the most relevant contribution was initially categorized by theme and subsequently synthesized into a narrative form.
86 articles were included, of which 27 were review articles, eight were surveys, and 51 were original articles. Our review systematically maps the research done in the last decade and provides an updated overview and the current state-of-the-art in this subject.
Despite discrepancies and heterogeneity in accumulating research, evidence gathered so far endorses a need for refining an escalating multiparameter diagnostic approach. A step-wise therapeutic plan appears to be the most reasonable management approach, starting with behavioral changes for mild to moderate, uncomplicated cases and escalating to personalized pharmacotherapy options for severe or nonresponsive cases. Surgical options could be considered in the most severe cases when potentially life-threatening symptoms persist despite maximal medical therapy. Over the past decade, the amount of available evidence has been gradually increasing; however, its strength remains low. Several aspects remain markedly under-addressed, and further adequately powered, multicenter, controlled studies with uniformity in diagnostic procedures and criteria are urgently needed.
喉咽反流可能影响任何年龄段的人群；然而，目前积累的大部分知识都集中在成年人身上，关于儿科人群的证据仍然相对有限。本研究旨在回顾过去十年中儿科喉咽反流的最新和新出现的方面。它还试图找出知识空白，并突出未来研究应迫切解决的差异。
对MEDLINE数据库进行电子检索，检索时间限制为2012年1月至2021年12月。排除非英语文章、病例报告以及纯粹或主要涉及成人人群的研究。来自贡献最相关文章的信息最初按主题分类，随后综合成叙述形式。
纳入86篇文章，其中27篇为综述文章，8篇为调查研究，51篇为原创文章。我们的综述系统地梳理了过去十年所做的研究，并提供了该主题的最新概述和当前的技术水平。
尽管在积累的研究中存在差异和异质性，但迄今为止收集的证据支持需要完善不断升级的多参数诊断方法。逐步治疗计划似乎是最合理的管理方法，对于轻度至中度、无并发症的病例，从行为改变开始，对于严重或无反应的病例，则升级到个性化的药物治疗方案。在最严重的病例中，如果尽管进行了最大程度的药物治疗，但潜在的危及生命的症状仍然存在，可以考虑手术选择。在过去十年中，可用证据的数量一直在逐渐增加；然而，其强度仍然较低。几个方面仍明显未得到充分探讨，迫切需要进一步开展有足够样本量、多中心、诊断程序和标准统一的对照研究。
