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Eosinophilic Laryngitis in Children with Aerodigestive Dysfunction.

Robert J Yawn1, Sari Acra2, Steven L Goudy1

  • 1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 31, 2015
PubMed
Summary
This summary is machine-generated.

Laryngeal eosinophils were found in 11% of children with aerodigestive dysfunction. Posterior arytenoid eosinophils may indicate chronic laryngeal inflammation and are linked to eosinophilic esophagitis.

Keywords:
adultaerodigestiveairwayairway reconstructionaspirationdysphagiadysphoniaeosinophiliaeosinophilic esophagitiseosinophilic laryngitisgastroesophageal refluxinflammatorylaryngeallaryngeal inflammationlaryngitislarynxpediatricrefluxsubglottic stenosisvoice

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Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Otolaryngology
  • Allergy and Immunology

Background:

  • Eosinophilic inflammation is increasingly recognized in various organ systems.
  • Laryngeal involvement in pediatric aerodigestive dysfunction is complex and multifactorial.
  • The presence and significance of laryngeal eosinophils in children are not well-established.

Purpose of the Study:

  • To investigate the prevalence of laryngeal eosinophils in pediatric patients with aerodigestive dysfunction.
  • To correlate laryngeal eosinophil presence with clinical symptoms and other gastrointestinal findings.
  • To explore the potential role of laryngeal eosinophils as a marker for chronic inflammation.

Main Methods:

  • A retrospective case series involving 81 pediatric patients referred to a multidisciplinary aerodigestive clinic.
  • Diagnostic procedures included microlaryngoscopy with posterior arytenoid biopsy, bronchoscopy, esophagogastroduodenoscopy with esophageal biopsy, and impedance probe testing.
  • Histopathological analysis of biopsies was performed to identify eosinophils and assess for laryngitis and esophagitis.

Main Results:

  • Eleven percent (9/81) of patients exhibited eosinophils in posterior arytenoid biopsies.
  • Three of these 9 patients also had biopsy-proven eosinophilic esophagitis.
  • Patients with posterior arytenoid eosinophils showed a significantly higher frequency of biopsy-proven eosinophilic esophagitis (33% vs. 6.9%, P = .0408).

Conclusions:

  • Eosinophilic inflammation in the larynx is a newly described finding in children with complex aerodigestive complaints.
  • Posterior arytenoid eosinophils may serve as a potential marker for chronic laryngeal inflammation in this patient population.
  • A threshold of >15 eosinophils/high-powered field in arytenoid biopsies was associated with concomitant eosinophilic esophagitis.