Conclusioni

Il reflusso faringo-laringeo non è univocamente determinabile. Nella pratica clinica è verosimile che tale patologia sia sovrastimata, in quanto ad essa vengono spesso attribuiti sintomi di altra origine e di difficile interpretazione funzionale da parte del Foniatria/Specialista ORL. Sulla base dei nostri risultati, i sintomi laringofaringei non sempre sono legati alla malattia da reflusso gastroesofageo e al reflusso laringofaringeo. Questo studio conferma che la valutazione clinica ORL/Foniatrica e l'applicazione degli score validati quali l'RSI e l'RFS per sospetto reflusso faringo-laringeo, tendono a sovrastimare la diagnosi di LPR, poichè meno del 50% dei soggetti presenta una vera patologia da reflusso (26,8%) o sono ipersensibili a reflussi fisiologici (21,4%). Dallo studio emerge inoltre che la sintomatologia correlata al reflusso faringo-laringeo risente maggiormente dei reflussi di tipo gassoso. E’ probabile che gli idrogenioni e/o la pepsina trasportati con i gas, si depositino a livello delle vie aeree superiori, determinando e favorendo il mantenimento del danno tissutale e della sintomatologia correlata. Inoltre, sebbene le scale RFS e RSI siano validate a livello internazionale, e utilizzate in ambito ORL/foniatrico, non è possibile identificare con accuratezza i pazienti con reflusso faringo-laringeo. Riteniamo pertanto, che l’eccessivo numero di “laringiti da reflusso” diagnosticate dallo specialista ORL/Foniatra derivi dalla mancanza di linee guida che possano rendere univoca, ripetibile e riproducibile la diagnosi di questa patologia e dal gran numero di condizioni patologiche che possono simulare una patologia da reflusso. Questi dati, che richiedono di conferma dallo studio di un numero maggiore di pazienti, acquisiscono oggi notevoli implicazioni clinico-diagnostiche e terapeutiche. Ulteriori studi su un numero maggiore di pazienti aiuteranno a capire la reale correlazione tra malattia da reflusso gastroesofageo e il reflusso faringo-laringeo.

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