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ENVER, NECATİ

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ENVER

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NECATİ

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2019 - 201912020 - 20211
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    Impact of subspecialty training on management of laryngopharyngeal reflux: results of a worldwide survey
    (SPRINGER, 2021) ENVER, NECATİ; Lechien, Jerome R.; Carroll, Thomas L.; Allen, Jacqueline E.; Ayad, Tareck; Enver, Necati; Eun, Young-Gyu; Perazzo, Paulo S.; Ceccon, Fabio Pupo; Sant'Anna, Geraldo D.; Imamura, Rui; Raghunandhan, Sampath Kumar; Chiesa-Estomba, Carlos M.; Calvo-Henriquez, Christian; Saussez, Sven; Karkos, Petros D.; Remacle, Marc; Akst, Lee M.; Bock, Jonathan M.
    Objective To study the management of laryngopharyngeal reflux (LPR) among the subspecialties of practicing otolaryngology-head and neck surgeons and their trainees. Methods A survey was sent to over 8000 otolaryngologists (OTOHNS) over 65 countries, utilizing membership lists of participating otolaryngological societies. The outcomes were answers to questions regarding LPR knowledge and practice patterns, and included queries about its definition, prevalence, clinical presentation, diagnosis, and treatment. Results Of the 824 respondents, 658 practiced in one specific otolaryngologic subspecialty. The symptoms and findings thought to be the most related to LPR varied significantly between subspecialists. Extra-laryngeal findings were considered less by laryngologists while more experienced OTOHNS did not often consider digestive complaints. Compared with colleagues, otologists, rhinologists and laryngologists were less aware of the involvement of LPR in otological, rhinological and laryngological disorders, respectively. Irrespective of subspecialty, OTOHNS consider symptoms and signs and a positive response to empirical therapeutic trial to establish a LPR diagnosis. Awareness regarding the usefulness of impedance pH-studies is low in all groups. The therapeutic approach significantly varies between groups, although all were in agreement for the treatment duration. The management of non-responder patients demonstrated significant differences among laryngologists who performed additional examinations. The majority of participants (37.1%) admitted to being less than knowledgeable about LPR management. Conclusions LPR knowledge and management vary significantly across otolaryngology subspecialties. International guidelines on LPR management appear necessary to improve knowledge and management of LPR across all subspecialties of otolaryngology.
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    Development of scores assessing the refluxogenic potential of diet of patients with laryngopharyngeal reflux
    (SPRINGER, 2019) ENVER, NECATİ; Lechien, Jerome R.; Bobin, Francois; Mouawad, Francois; Zelenik, Karol; Calvo-Henriquez, Christian; Chiesa-Estomba, Carlos M.; Enver, Necati; Nacci, Andrea; Barillari, Maria Rosaria; Schindler, Antonio; Crevier-Buchman, Lise; Hans, Stephane; Simeone, Virginie; Wlodarczyk, Elzbieta; Harmegnies, Bernard; Remacle, Marc; Rodriguez, Alexandra; Dequanter, Didier; Eisendrath, Pierre; Dapri, Giovanni; Finck, Camille; Karkos, Petros; Pendleton, Hillevi; Ayad, Tareck; Muls, Vinciane; Saussez, Sven
    Objective To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR). Methods European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient. Results Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively. Conclusion REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance-pH study.