Endoscopic Features of Chronic Rhinosinusitis in Patients with Gastroesophageal Reflux Disease
Sagandykova K. Papulova N. Azhenov T. Darbekova A. Aigozhina B. Lechien J.R.
August 2024Multidisciplinary Digital Publishing Institute (MDPI)
Medicina (Lithuania)
2024#60Issue 8
Chronic rhinosinusitis (CRS) is a complex inflammatory condition affecting the nasal and paranasal sinus mucosa. Gastroesophageal reflux disease (GERD) has been implicated as a potential exacerbating factor in CRS, but the specific endoscopic features of nasopharyngeal pathology in this context remain poorly understood. Background and Objectives: Chronic rhinosinusitis is a multifactorial disease with various underlying etiologies, including inflammation, anatomical factors, and environmental triggers. While gastroesophageal reflux disease has been suggested as a potential contributor to chronic rhinosinusitis, the specific endoscopic features indicative of nasopharyngeal pathology in CRS patients with GERD symptoms have not been clearly elucidated. Our aim is to identify specific endoscopic features of nasopharyngeal pathology in patients with CRS associated with GERD symptoms and to propose a method for assessing the influence of gastroesophageal reflux disease on the mucosal layer of the nose and nasopharynx. Materials and Methods: We conducted a cross-sectional observational study involving 521 adult patients presenting with symptoms suggestive of CRS. From this cohort, 95 patients with the highest scores on the Reflux Symptom Index (RSI) and Reflux Symptom Score-12 (RSS-12) questionnaires were selected as the main group. Endoscopic examinations were performed to assess the nasal and nasopharyngeal mucosa. Results: Our study revealed significant alterations in the nasopharyngeal mucosa of patients with CRS associated with GERD symptoms. Increased vascularity of the nasopharyngeal mucosa was observed in 91 patients (95.7%), while hypertrophy was noted in 83 patients (87.4%). Mucus was present in the nasopharynx of 77 patients (81.1%), exhibiting varying characteristics of color and consistency. Asymmetric hypertrophy of the oropharyngeal mucosa was noted in 62 patients (65.3%). Conclusions: We propose a method for assessing the influence of gastroesophageal reflux disease on the mucosal layer of the nose and nasopharynx, which may aid in diagnostic and management decisions. Further research is warranted to explore the potential impact of GERD symptoms on the course and severity of CRS exacerbations.
endoscopic picture , laryngopharyngeal reflux , nasopharyngeal reflux , rhinosinusitis , the Reflux Symptom Index , the Reflux Symptom Score
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“University Medical Center” Corporate Fund, School of Medicine, Nazarbayev University (NUSOM), Astana, 010000, Kazakhstan
Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana, 010000, Kazakhstan
Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, 010000, Kazakhstan
Laryngopharyngeal Reflux Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, 13005, France
Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris, 78180, France
School of Medicine, University Paris Saclay, Paris, 91190, France
“University Medical Center” Corporate Fund
Department of Otorhinolaryngology
Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan
Laryngopharyngeal Reflux Study Group
Department of Otolaryngology-Head and Neck Surgery
School of Medicine
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