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Gastroesophageal Reflux and Pediatric Otolaryngologic Disease
The Role of Antireflux Surgery
Dana L. Suskind, MD;
Guy P. Zeringue III, MD;
Evelyn A. Kluka, MD;
John Udall, MD;
Donald C. Liu, MD, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:511-514.
Objective To determine the role of antireflux surgery in the treatment of gastroesophageal
reflux–induced otolaryngologic disease (GEROD).
Design A retrospective medical record analysis was performed. Patient demographics,
otolaryngologic disease secondary to gastroesophageal reflux (GER), method
of GER diagnosis, medical treatment used before antireflux surgery, and response
to surgical intervention were considered.
Setting Tertiary care children's hospital.
Patients Among patients undergoing antireflux surgery between January 1, 1996,
and December 31, 1999, children with GEROD were included in the study.
Interventions Children with GEROD who failed medical therapy underwent antireflux
surgery.
Main Outcome Measures The demographics of patients requiring antireflux surgery for treatment
of their otolaryngologic disease and their clinical response to surgery were
reviewed.
Results Fourteen (17%) of 82 children, ranging in age from 48 days to 3 years
(mean age, 9.7 months), who underwent antireflux surgery for GER at our institution
between 1996 and 1999 were diagnosed as having GEROD. Twelve (86%) of the
14 patients were found to have upper airway abnormalities, including subglottic
edema, fixed subglottic stenosis, reflex apnea, and recurrent croup. Two patients
(14%) had severe chronic sinusitis and otitis media. Nine (64%) of the 14
had normal neurologic function for their age vs 5 (36%) who had neurologic
impairment. After antireflux surgery, all 14 patients with GEROD had complete
resolution of clinical symptoms.
Conclusions Gastroesophageal reflux has an important role in the cause of numerous
otolaryngologic disorders. Although medical management should remain the mainstay
of GER therapy, antireflux surgery provided definitive and successful treatment
of potentially life-threatening manifestations of GEROD.
From the Departments of Otolaryngology (Drs Suskind, Zeringue, and
Kluka), Pediatric Gastroenterology (Dr Udall), and Pediatric Surgery (Dr Liu),
Louisiana State University Medical Center at New Orleans.
Corresponding author and reprints: Dana L. Suskind, MD, Department
of Otolaryngology, Louisiana State University Medical Center at New Orleans,
200 Henry Clay Ave, New Orleans, LA 70118 (e-mail: susliu{at}lsuhsc.edu).
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