Bidirectional risk between adenoid hypertrophy and LPR in children

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Created On: 29/12/2025

Adenoid hypertrophy, Laryngopharyngeal reflux

Adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) frequently occur together in children, driven by overlapping inflammatory and anatomical pathways.

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Key take away

Children with adenoid hypertrophy show a 10-fold higher likelihood of laryngopharyngeal reflux, confirming a significant reciprocal relationship.

Background

Adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) frequently occur together in children, driven by overlapping inflammatory and anatomical pathways. This study investigated the bidirectional association between AH and LPR in pediatric populations through a systematic meta-analysis.

Method

The research team conducted a structured search across PubMed, Web of Science, and the Cochrane Library to identify relevant studies. The quality of cohort research was judged via the Newcastle–Ottawa Scale, whereas cross-sectional studies were appraised via the appraisal tool for cross-sectional studies (AXIS) checklist. Through funnel-plot inspection, potential publication bias was explored. All extracted data were pooled and analyzed using the R statistical platform (version 4.4.2) to quantify the directional risks between AH and LPR.

Result

Eighteen studies involving 39,427 children qualified for inclusion.

AH dramatically increased the likelihood of LPR, with affected children experiencing more than a tenfold rise in risk [odds ratio = 10.53].
Repeated adenoidectomy (AT) was also linked to heightened reflux susceptibility [risk ratio (RR) = 9.43].
Although reflux symptoms improved within the first year after surgery, long-term follow-up revealed a higher risk of LPR recurrence (RR = 2.03).

These patterns confirmed that AH and LPR impact each other in a reciprocal way.

Conclusion

This analysis demonstrated a strong two-way relationship between AH and LPR in children. While AT offered short-term symptomatic relief, long-term vulnerability to reflux persisted, underscoring a complex inflammatory interplay. Standardized diagnostic protocols are essential for future research to better clarify this reciprocal link, given the considerable heterogeneity in current diagnostic approaches.