Anyone who has lauged hard enough to have liquid come out of the nose has experienced pharyngonasal reflux. Pharyngonasal reflux involves passage of material from the oropharynx, pharynx and hypopharynx into the nasopharynx and nares while swallowing.


Transient pharyngonasal reflux is relatively common in neonates and during the first 3 months of life.


Pathological pharyngonasal reflux may be associated with:

(1) frequent apneic episodes

(2) prematurity

(3) neuromuscular disorders (dysautonomia, myopathy)

(4) velopharyngeal incoordination or palatoesophageal dyskinesia

(5) disorders of the soft palate (surgical, congenital, tumor)

(6) cleft palate


The reflux can be demonstrated on imaging studies by demonstrating the passage of contrast medium from the pharynx into the nasopharynx and nares.


The evaluation of a patient with a cleft palate may try to distinguish between reflux through the pharynx from leakage through the defect in the oropharynx. A palate obturator may be used to occlude the defect in the hard palate.


Complications or associated findings:

(1) otitis if fluid enters the middle ear

(2) difficulty with feedings

(3) aspiration pneumonia


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