M M Carr1, M L Nagy, M P Pizzuto, C P Poje, L S Brodsky. 1. EN7-238, Department of Otolaryngology, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4. mm.carr@utoronto.ca
Abstract
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 (i.e., 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.
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 (i.e., 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.
Authors: Ahmed Alrahim; Askar K Alshaibani; Saad Algarni; Abdulmalik Alsaied; Amal A Alghamdi; Salma Alsharhan; Mohammad Al-Bar Journal: Int J Environ Res Public Health Date: 2022-04-30 Impact factor: 4.614