Gastroesophageal reflux association with laryngomalacia: a prospective study

Abstract

Objective: To identify the incidence and clinical role of gastroesophageal reflux (GER) in patients with laryngomalacia. Design: Prospective evaluation of consecutive infants with a new diagnosis of laryngomalacia with an initial questionnaire, a barium esophagram or 24 h pH probe and record of their subsequent clinical course. Setting: A large, tertiary pediatric referral center and its associated outpatient clinic. Patients: New diagnosis of laryngomalacia in 33 consecutive infants were evaluated by questionnaire and 27 of these were evaluated for GER. Results: GER was observed in 64% of patients and was significantly associated with severe symptoms and complicated clinical course (P=0.0163). The presence of smokers in the infant's household negatively impacted his or her clinical course and symptomatology (P=0.013) as did the presence of other major, concurrent medical problems (P=0.065). Conclusions: In patients with laryngomalacia, GER was significantly associated with severe symptoms (a complicated clinical course), as was smoking in an infant's household and other significant medical problems.