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Gastroesophageal reflux contributing to chronic sinus disease in children: a prospective analysis
C D Phipps1, W E Wood, W S Gibson
1Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA 17822, USA.
Insights
Gastroesophageal reflux (GER) is common in children with chronic sinus disease (CSD). Treating GER significantly improved sinus symptoms in most affected children, suggesting GER evaluation before sinus surgery.
Area of Science:
- Pediatric Otolaryngology
- Gastroenterology
- Chronic Sinus Disease Research
Background:
- Chronic sinus disease (CSD) in children can be challenging to manage.
- The role of gastroesophageal reflux (GER) in pediatric CSD is not well-established.
Purpose of the Study:
- To investigate the prevalence of GER and nasopharyngeal reflux in children diagnosed with CSD.
- To assess the impact of GER treatment on CSD symptoms in pediatric patients.
Main Methods:
- A descriptive prevalence study was conducted in pediatric otolaryngology and gastroenterology clinics.
- Thirty children (aged 2-18) with CSD underwent 24-hour dual pH probe monitoring and completed questionnaires.
- GER treatment response was evaluated in patients diagnosed with GER.
Main Results:
- Esophageal reflux was identified in 63% of children with CSD, significantly higher than the general population.
- Nasopharyngeal reflux was present in 32% of those with esophageal reflux.
- Fifteen of 19 patients (79%) with GER showed improvement in sinus disease after GER treatment.
Conclusions:
- Pediatric CSD patients exhibit a high prevalence of GER.
- Treatment of GER led to significant improvement in sinus disease for most affected children.
- Evaluation and treatment of GER are recommended for children with refractory CSD before considering surgical interventions.
Objective:
To explore the possible role of gastroesophageal reflux (GER) in children with chronic sinus disease (CSD).
Design:
A descriptive prevalence study of the frequency of GER and nasopharyngeal reflux in children with CSD.
Setting:
Pediatric otolaryngology and gastroenterology outpatient clinics of a regional medical center.
Patients And Other Participants:
Consecutive children aged 2 to 18 years referred for evaluation of CSD from December 1, 1996, through April 30, 1998.
Interventions:
Participants underwent 24-hour monitoring with dual pH probes, and participants (or their parents) completed questionnaires before treatment and at specific intervals after treatment.
Main Outcome Measures:
Prevalence of GER and nasopharyngeal reflux in children with CSD, and the response of sinusitis to treatment in those diagnosed with GER.
Results:
Nineteen (63%) of 30 patients demonstrated esophageal reflux, which is well above the expected prevalence of GER in the healthy general population. Six (32%) of these 19 patients demonstrated nasopharyngeal reflux. Fifteen (79%) of 19 patients improved after treatment for GER.
Conclusions:
The children in this population had a prevalence of GER that was significantly higher than expected. Furthermore, most children with GER demonstrated improvement of sinus disease after treatment of GER. We recommend that children with CSD refractory to aggressive medical management be evaluated for GER and, if GER is present, be treated accordingly, before sinus surgery is considered.
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