Correlation Between Recurrent Chronic Rhinosinusitis And Laryngopharyngeal Reflux Disease

Objective To explore the correlation between recurrent chronic sinusitis and laryngopharyngeal reflux disease,and to analyze the risk factors of recurrent chronic sinusitis,so as to provide new diagnosis and treatment ideas for clinical diagnosis and treatment of CRS.Methods From September 2018 to December 2019,154 patients in the otolaryngology head and neck surgery department of Ningxia Medical University General Hospital and cardiovascular and cerebrovascular hospital and volunteers in the same hospital were selected as the subjects of study.104 patients were diagnosed as chronic rhinosinusitis,including 53 patients with recurrent chronic rhinosinusitis as the recurrent CRS group and 51 patients with chronic rhinosinusitis as the CRS group,50 healthy volunteers as the control group.All subjects were assessed with the reflow symptom scale and reflow symptom scale,RSI > 13 and / or RFS > 7,and were initially diagnosed as laryngopharyngeal reflux disease.At the same time,the nasal secretions of all the subjects were collected,and the concentration of pepsin in the nasal secretions was detected by pepsin detection reagent.If the concentration of pepsin was more than 75 ng / ml,it was diagnosed as throat reflux disease.The results of pepsin,RSI and RFS were compared among the three groups,and the correlation between the severity of laryngopharyngeal reflux disease and chronic rhinosinusitis was analyzed.Results There was no significant difference in sex,age,height,weight and proportion of drinking between the recurrent CRS group,CRS group and the control group(P > 0.05);and there was significant difference in smoking proportion between the recurrent CRS group and the control group(P < 0.05).The results of RSI and RFs in three groups were analyzed: 21 cases were positive in recurrent CRS group,with a positive rate of 39.6%;27 cases were positive in CRS group,with a positive rate of 52.9%;7 cases were positive in control group,with a positive rate of 14.0%.The positive rate of RSI + RFs in three groups was compared,the difference was statistically significant(P < 0.05),and the positive rate of RSI + RFs in recurrent CRS group and CRS group was higher than that in control group.Analysis of pepsin test results in three groups: 23 cases were positive in recurrent CRS group,with a positive rate of 43.4%;33 cases were positive in CRS group,with a positive rate of 64.7%;9 cases were positive in control group,with a positive rate of 18.0%.The positive rate of pepsin in three groups was compared,the difference was statistically significant(P < 0.05),and the positive rate of pepsin in recurrent CRS group and CRS group was higher than that in control group.Analysis of the results of pepsin test and RSI,RFS: the positive results of pepsin test in nasal secretion were taken as the criteria for the diagnosis of laryngopharyngeal reflux.The sensitivity and specificity of RSI combined with RFs were 75.4% and 93.3%,respectively.Pepsin test results and visual analog scale correlation analysis: the positive rate of pepsin in patients with severe,moderate and mild VAS scores were compared,the difference was statistically significant(P < 0.05).Based on the mild VAS score,the positive rate of pepsin in in patients with severe and moderate VAS scores was 3.514 and 2.750 times higher than that in patients with mild VAS scores.Conclusion laryngopharyngeal reflux disease and smoking may be the risk factors of CRS recurrence.There is a correlation between laryngopharyngeal reflux disease and CRS,which may be one of the causes of CRS.RSI and RFS are sensitive,which can be used to screen suspected throat laryngopharyngeal reflux in adult CRS patients in Ningxia There is a positive correlation between the severity of CRS and laryngopharyngeal reflux disease.Considering the laryngopharyngeal reflux disease is one of the risk factors of aggravating CRS.