Experience with the management of pediatric laryngopharyngeal reflux in an Indian teaching hospital

Abstract

Aim: Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric content to the larynx and pharynx where these materials come in contact to the upper aerodigestive tract. This clinical entity is less studied among the pediatric population. The objective of this study is to evaluate the impact of LPR in the pediatric population. Materials and Methods: This retrospective study was done in between December 2016 and January 2019. Clinical data such as associated symptoms, endoscopic findings, laboratory testing, therapeutic interventions, and outcome were analyzed. Endoscopic findings were considered to be consistent with LPR in the pediatric age included: Lingual tonsil hypertrophy, postglottic edema, true vocal fold edema and congested and swollen arytenoids, congested inter-arytenoids area. Results: There were 212 children evaluated for dysphonia. There were 38 girls (52.77) and 34 boys (47.22%), and mean age at presentation was 9.32 years with a male-to-female ratio of 0.89:1. Out of 212 children who underwent endoscopy, 72 had shown LPR disease. Five children (6.94%) showed vocal nodules, 3 (4.16%) showed vocal fold cyst, and 2 (2.77%) children showed subglottic edema along with LPR. All the children were treated with anti-reflux measures. By second follow-up visit on 1 month, 68 children (94.44%) had improved symptomatically. Conclusion: LPR appears to cause laryngeal manifestations more commonly in children. In this study, all the children were presenting dysphonia, intermittent cough, foreign-body sensation in throat, and throat-clearing habit. All of them showing congested arytenoids and inter-arytenoid membrane. Early diagnosis and treatment often result in the improvement of hoarseness of voice and prevent complications. LPR in the pediatric population is almost a new diagnosis.