Laryngopharyngeal reflux (LPR) manifests as a variety of nonspecific upper aerodigestive tract symptoms. Rather than a single disorder, LPR may be conceived of as a spectrum of subtypes with varying clinical presentations. LPR signs and symptoms arise from the direct and/or indirect effects of refluxate, physical and molecular injury of the mucosa, and neurologic responses to esophageal events. Specific constituents of refluxate exert distinct mucosal responses and immediate or delayed effects resulting in transient or persistent symptoms and/or laryngeal hypersensitivity. While the complex etiology of LPR presents challenges to its diagnosis and management, tools that aid the identification of LPR subtypes can provide insight into treatment decision-making. Hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring provides detailed analysis of reflux events, enabling the development of individualized treatment plans, yet cost and availability limit its widespread use. Alginates offer temporary symptom relief and antireflux surgery may provide benefit when symptoms are recalcitrant to other approaches. Pepsin inhibitors hold promise as a medical therapy when surgery is not an option. Laryngeal hypersensitivity should be considered as part of a comprehensive therapeutic approach. Promising medical and scientific research continues to yield new insights into the complex etiology of LPR and novel strategies for its diagnosis and management.

中文翻译：

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喉咽反流的病因、诊断和治疗进展


喉咽反流 （LPR） 表现为多种非特异性上呼吸消化道症状。LPR 可能不是一种单一的疾病，而可能被认为是一系列具有不同临床表现的亚型。LPR 体征和症状由反流、黏膜的物理和分子损伤以及对食管事件的神经系统反应的直接和/或间接影响引起。反流的特定成分产生不同的粘膜反应和即时或延迟效应，导致短暂或持续的症状和/或喉过敏。虽然 LPR 的复杂病因对其诊断和管理提出了挑战，但有助于识别 LPR 亚型的工具可以为治疗决策提供见解。近咽-食管多通道腔内阻抗-pH 监测可对反流事件进行详细分析，从而能够制定个体化治疗计划，但成本和可用性限制了其广泛使用。藻酸盐可暂时缓解症状，当症状对其他方法难以治疗时，抗反流手术可能有益。胃蛋白酶抑制剂在无法选择手术时有望作为一种药物治疗。喉超敏反应应被视为综合治疗方法的一部分。有前景的医学和科学研究继续为 LPR 的复杂病因及其诊断和管理的新策略提供新的见解。