Extraesophageal reflux – otorhinolaryngological complication of gastroesophageal reflux

Česká verze

Authors: M. Brndiarová ^1,3 ; J. Mikler ^1,3; Peter Bánovčin ^1,3 ; T. Michnová ²; J. Fábry ²
Authors place of work: Klinika detí a dorastu, Jesseniova lekárska fakulta Univerzity Komenského ; Univerzitná nemocnica Martin prednosta prof. MUDr. P. Bánovčin, CSc. Klinika respiračných chorôb a detskej tuberkulózy, Jesseniova lekárska fakulta Univerzity Komenského v Martine, Šrobárov ústav detskej tuberkulózy a respiračných chorôb ¹; Dolný Smokovec poverený riadením MUDr. J. Fábry, PhD. Centrum experimentálnej a klinickej respirológie, Jesseniova lekárska fakulta Univerzity ²; Komenského, Martin prednosta prof MUDr. P. Bánovčin, CSc ³
Published in the journal: Čes-slov Pediat 2011; 66 (2): 85-91.
Category: Původní práce

Summary

Introduction:
The aim of this prospective study was evaluated the characteristics of extraesophageal reflux (EER) and comparative analysis of parameters of 24 hours intraesophageal pH monitoring in children with gastroesophageal reflux disease (GERD) and EER.

Material and methodes:
Study population was consisted of 119 children (30 with GERD, 30 with positive laryngoscopy for EER, 59 with positive otorinolaryngological disorders without positive laryngoscopy). The median age of the patients was 9 years (quartile 60–12 years). Children were underwent 24 hour intraesophageal pH monitoring with two sensors and flexibile laryngoscopy. We collected information about family, personal, allergic and drugs medical history. The Mann-Whitney U test and χ2 test were used to assess intergroup comparisons.

Results:
Children with gastroesophageal reflux had high prevalence of otorinolaryngological disorders. The typical signs of flexibile laryngoscopy (group II) were laryngitis posterior (43.3%). Male sex was often with EER and GERD. The typical symptomps for children with GERD (group I) in comparative to group II and group III were vomiting (18/2, p<0.001) and abdominal pain (24/9, p<0.001) group II, vomiting (18/6, p<0.001) and abdominal pain (24/23, p=0.001) group III. In 24 hours intraesophageal pH monitoring the nocturnal reflux and reflux in supine possition were typical for group I and daytime reflux and reflux in upright possition were predominantly for group II and III. Duration of the longest reflux was longer in pacients with GERD as patients with EER in distal sensor (group I vs. group II 17/8, p<0.05, group I vs. group II, III 17/8, p<0.05).

Conclusion:
EER is still largely controversial. It is essential to elucidate the molecular basis of pathophysiologic processes with influened the upper esophageal sphincter and the upper airway mucosa and lead to LPR with variation. This could help in discovering of the better diagnostic methods, the treatment and monitoring of EER.

Key words:
extraesophageal reflux, children, 24 hours intraesophageal pH monitoring, gastroesophageal reflux

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