Proton Pump Inhibitor for Enlarged Lingual Tonsils

Main Hypothesis: The investigators hypothesize that measurements of lingual tonsil tissue (LTT) thickness will decrease following treatment with once daily oral dexlansoprazole 60 mg in patients diagnosed with laryngopharyngeal reflux (LPR) and lingual tonsil hypertrophy (LTH) compared to matched controls receiving placebo. Primary endpoints include: 24-hour oropharyngeal pH testing, pre- and post-treatment Mean lingual tonsil tissue (LTT) thickness, pre- and post-treatment, as determined by CT scan of the base of tongue Secondary endpoints include: Reflux Finding Score (RFS) on pre- and post-treatment endoscopy of the oropharynx Subjective outcome metrics for assessing LPR-related symptoms and associated quality of life Calgary Sleep Apnea Quality of Life Index Bed-partner assessment of snoring intensity according to a Visual Analog Scale Epworth Sleepiness Scale (ESS) Reflux Symptom Index (RSI) Specific Aims: The primary objective of this study is to determine whether treatment of patients diagnosed with LPR and LTH with 3 months of PPI therapy reduces LTT thickness, as measured on CT scan of the tongue base. The secondary objectives of this study are to: Evaluate changes in LPR-related symptoms and quality of life after therapy using the following subjective outcome metrics: Calgary Sleep Apnea Quality of Life Index Bed-partner assessment of snoring intensity according to a Visual Analog Scale Epworth Sleepiness Scale Reflux symptom index Correlate changes in LTT thickness with the following secondary endpoints: Changes in the above subjective outcome metrics Changes in endoscopic findings of LPR Changes in 24-hour oropharyngeal pH study results