This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (14)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Pediatric Otolaryngology  • Surgery  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

A Prospective Study

Michele M. Carr, DDS, MD, MEd, FRCSC; Mark L. Nagy, MD; Michael P. Pizzuto, MD; Christopher P. Poje, MD; Linda S. Brodsky, MD

Arch Otolaryngol Head Neck Surg. 2001;127:369-374.

Objective  To correlate direct laryngoscopic and bronchoscopic findings with the presence of positive test results for gastroesophageal reflux disease (GERD) in children.

Design  Prospective collection of structured data.

Setting  An academic pediatric otolaryngology department.

Patients  Seventy-seven consecutive patients who underwent direct laryngoscopy and bronchoscopy between June and October 1999.

Interventions  During direct laryngoscopy and bronchoscopy, descriptions of 7 laryngeal and 6 cricotracheal findings were recorded on a 3-point scale (ie, absent, mild, or severe). Medical records were later reviewed to obtain results of the following tests, if they were part of the record: gastric scintiscan, 24-hour pH probe monitoring, upper gastrointestinal tract series, and esophageal biopsy.

Main Outcome Measures  Correlation of mucosal abnormalities with the presence or absence of a positive test result for GERD.

Results  Fifty (65%) of 77 patients had GERD diagnosed with at least 1 positive test result, 21 (27%) had no clinical symptoms and no positive GERD test results, and 5 (7%) had clinical symptoms but no positive test results. There were significant differences for total laryngeal and cricotracheal scores (P<.001) between the groups with positive and negative results. Significant differences were as follows: in the larynx—large lingual tonsil (P<.001), postglottic edema (P<.001), arytenoid edema (P<.001), ventricle obliteration (P = .03), and true vocal fold edema (P = .001), and in the cricotracheal region—general edema and erythema (P = .003) and blunting of the carina (P<.001). Severe arytenoid edema, postglottic edema, or enlargement of lingual tonsil were pathognomonic of GERD.

Conclusion  Many direct laryngoscopic and bronchoscopic findings correlate well with the diagnosis of GERD as determined by using other tests.

From the Department of Pediatric Otolaryngology, Children's Hospital of Buffalo, Buffalo, NY. Dr Carr is now with the Department of Otolaryngology, Toronto General Hospital, Toronto, Ontario.

Corresponding author: Michele M. Carr, DDS, MD, MEd, FRCSC, EN7-238, Department of Otolaryngology, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4 (e-mail: mm.carr{at}utoronto.ca).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(4):470.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Comparison of Pediatric Voice Outcome Survey, Reflux Symptom Index, Reflux Finding Score, and Esophageal Biopsy Results
Simons et al.
Arch Otolaryngol Head Neck Surg 2008;134:837-841.
ABSTRACT | FULL TEXT  

Lack of Association Between Esophageal Biopsy, Bronchoalveolar Lavage, and Endoscopy Findings in Hoarse Children
Mandell et al.
Arch Otolaryngol Head Neck Surg 2004;130:1293-1297.
ABSTRACT | FULL TEXT  

Extraesophageal Reflux in Pediatric Patients With Upper Respiratory Symptoms
Rosbe et al.
Arch Otolaryngol Head Neck Surg 2003;129:1213-1220.
ABSTRACT | FULL TEXT  

Recurrent Lingual Tonsil Hyperplasia
Parham and Newman
Arch Otolaryngol Head Neck Surg 2003;129:1010-1012.
ABSTRACT | FULL TEXT