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Role of gastroesophageal reflux in pediatric upper airway disorders
1Department of Otolaryngology and Communicative Sciences, Medical University of South Carolina, Charleston 29425, USA.
Insights
Gastroesophageal reflux (GER) significantly impacts pediatric upper airway issues. This review links GER to conditions like subglottic stenosis, croup, apnea, and chronic cough, highlighting its role in various respiratory problems.
Area of Science:
- Pediatric Otolaryngology
- Gastroenterology
- Respiratory Medicine
Background:
- Gastroesophageal reflux (GER) into the laryngopharynx is implicated in numerous pediatric upper respiratory conditions.
- Understanding the specific role of GER in these disorders is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To review and quantify the contribution of GER to various pediatric upper airway disorders.
- To determine the causative or contributory role of GER in specific conditions.
Main Methods:
- Review of pH probe data, laryngeal examinations, and bronchoalveolar lavage results.
- Analysis of patient data for conditions including subglottic stenosis, recurrent croup, apnea, chronic cough, laryngomalacia, recurrent choanal stenosis, vocal fold nodules, and chronic sinusitis/otitis/bronchitis.
Main Results:
- GER plays a causative role in subglottic stenosis, recurrent croup, apnea, and chronic cough.
- GER acts as an important inflammatory cofactor in laryngomalacia, vocal fold nodules, and recurrent choanal stenosis.
- GER is an important inflammatory cofactor in chronic sinusitis/otitis/bronchitis, potentially a result of chronic illness in older children.
Conclusions:
- GER is a significant factor in several pediatric upper airway disorders.
- GER's role ranges from direct causation to exacerbation as an inflammatory cofactor.
- Further investigation into GER management may be beneficial for these pediatric conditions.
Abstract:
Gastroesophageal reflux (GER) into the laryngopharynx causes or contributes significantly to a variety of upper respiratory problems in children. The pH probe, laryngeal examinations, and broncholveolar lavage results for children with subglottic stenosis, recurrent croup, apnea, chronic cough, laryngomalacia, recurrent choanal stenosis, vocal fold nodules, and chronic sinusitis/otitis/bronchitis were reviewed in an effort to quantify the role of GER in each of these disorders. This review suggests that GER plays a causative role in subglottic stenosis, recurrent croup, apnea, and chronic cough. It is an important inflammatory cofactor in laryngomalacia and possibly in true vocal cord nodules and problematic recurrent choanal stenosis. GER is also an important inflammatory cofactor in chronic sinusitis/otitis/bronchitis but may be the result of chronic illness in the older patients.