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Role of laryngoscopy in children with respiratory complaints and suspected reflux
S Ozmen1, F Demirceken, Y Barut
1Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Clinic of Pediatric Allergy and Asthma, Ankara, Turkey. serapozmen@yahoo.com
Insights
Laryngopharyngeal reflux (LPR) in children can cause respiratory issues. Laryngoscopy showed limited sensitivity and specificity for diagnosing LPR/GERD, highlighting the need for combined diagnostic approaches.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Pediatric Pulmonology
Background:
- Laryngopharyngeal reflux (LPR) is increasingly recognized in pediatric patients.
- Respiratory symptoms like chronic cough and hoarseness can be indicative of LPR in children.
Purpose of the Study:
- To evaluate laryngoscopic findings in children diagnosed with LPR and/or gastroesophageal reflux disease (GERD).
- To determine the diagnostic utility of laryngoscopy for LPR/GERD in pediatric patients.
Main Methods:
- Retrospective analysis of 49 pediatric patients with respiratory complaints suggestive of LPR.
- Diagnosis of LPR/GERD based on clinical history, 24-hour double-probe pH monitoring, and/or scintigraphy.
- Fiber optic laryngoscopy was performed on 38 of the 49 patients.
Main Results:
- Thirty of 38 patients (79%) with available diagnostic tests were confirmed to have LPR/GERD.
- Only 12 of these 30 patients (40%) exhibited positive laryngeal findings on laryngoscopy.
- Arytenoid erythema was the most common laryngoscopic finding (8 cases); overall sensitivity was 40% and specificity 50%.
Conclusions:
- Laryngopharyngeal reflux should be suspected in children with unexplained respiratory symptoms.
- Laryngoscopy alone has limited diagnostic value for LPR/GERD in children.
- Integrated evaluation of clinical history and objective diagnostic tests is crucial for diagnosing pediatric LPR.
Background:
In recent years, laryngopharyngeal reflux (LPR) in children has been taken into consideration.
Objective:
The aim of this study was to assess the laryngoscopic findings in children diagnosed LPR and/or gastro-oesophageal reflux (GERD).
Methods:
The findings of 49 patients with at least one or more respiratory complaint such as chronic cough, wheezing, hoarseness, recurrent laryngitis, and throat clearing/postnasal discharge suggesting LPR were evaluated retrospectively. The diagnosis of LPR+GERD or GERD was done by the clinical history and 24 h double-probe pH monitoring and/or scintigraphy.
Results:
Thirty eight out of 49 patients examined by laryngoscopy underwent 24 h double-probe pH monitoring and/or scintigraphy. Thirty of them were diagnosed as LPR+GERD or GERD by any test positivity. Twelve of 30 patients diagnosed with LPR+GERD or GERD had a positive laryngeal finding on the examination of fibre optic laryngoscopy. The most common finding with eight cases was arytenoid erythema A sensitivity of 40% and specificity of 50% for the laryngoscopy in the diagnosis of LPR/GERD were found.
Conclusion:
In children with unexplained respiratory symptoms, laryngopharyngeal reflux should be suspected. Therefore, until enough data on this issue in the literature accumulates, the history and the laboratory findings of the patients obtained from various techniques to document paediatric LPR should be evaluated together.
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