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Hoarseness and gastroesophageal reflux in children

Published online by Cambridge University Press:  29 June 2007

Louise Gumpert
Affiliation:
Departments of Oto-rhino-laryngology, Hôpital Saint Vincent de Paul, Faculté Cochin Paris Cedex 14, France.
Nicolas Kalach
Affiliation:
Departments of Paediatric Gastroenterology, Hôpital Saint Vincent de Paul, Faculté Cochin Paris Cedex 14, France.
Christophe Dupont
Affiliation:
Departments of Paediatric Gastroenterology, Hôpital Saint Vincent de Paul, Faculté Cochin Paris Cedex 14, France.
Philippe Contencin*
Affiliation:
Departments of Oto-rhino-laryngology, Hôpital Saint Vincent de Paul, Faculté Cochin Paris Cedex 14, France.
*
Address for correspondence: Dr Philippe Contencin, Service d'ORL, Hôpital Saint Vincent de Paul, 82, Avenue Denfert-Rochereau, 75674 Paris Cedex 14, France. Fax: 0033 140488320

Abstract

The importance of a hoarse voice or voice change in children has not been stressed in the literature in the same way as it has been in adults. We present 21 children who had been suffering from chronic hoarseness for more than three months and had on fibre-optic laryngoscopy findings suggestive of gastroesophageal reflux. None of them had complained of gastroesophageal symptoms. Twenty-four hour pH monitoring revealed that 13 (62 per cent) of these children had gastroesophageal reflux, seven (33 per cent) having gastroesophageal reflux more than three times the upper limit of normal. The pH graphs highlighted frequent refluxes, ranging from 0.4 to 37.4 refluxes per hour (median of 7.3 refluxes/hour). The majority of these refluxes occurred when the child was awake as opposed to asleep, with a median of 14.8 refluxes/hour and 0.9 refluxes/hour respectively (p = 0.0009). The refluxes were classically of short duration. This study suggests that gastroesophageal reflux plays a direct role in the pathogenesis of chronic laryngitis and hoarseness in children.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1998

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References

Bain, W. M, Harrington, J. W., Thomas, L. E., Schaefer, S. D. (1983) Head and neck manifestations of gastroesophageal reflux. Laryngoscope 93: 175179.CrossRefGoogle ScholarPubMed
Burton, D. M, Pransky, S. M., Katz, R. M., Kearns, D. B., Seid, A. B. (1992) Pediatric airway manifestations of gastroesophageal reflux. Annals of Otology, Rhinology and Laryngology 101: 742749.CrossRefGoogle ScholarPubMed
Cherry, J., Margulies, S. I. (1968) Contact ulcer of the larynx. Laryngoscope 73: 19371940.CrossRefGoogle Scholar
Cohen, S. R., Thompson, J. W., Geller, K. A., Birns, J. W. (1983) Voice change in the paediatric patient; A differential diagnosis. Annals of Otology, Rhinology and Laryngology 92: 437443.CrossRefGoogle ScholarPubMed
Contencin, P., Maurage, C., Ployet, M. J., Seid, A. B., Sinaasappel, M. (1995) Gastroesophageal reflux and ENT disorders in childhood. International Journal of Pediatric Otorhinolaryngology 32: 135144.CrossRefGoogle ScholarPubMed
Cote, D. N., Miller, R. H. (1995) The association of gastroesophageal reflux and otolaryngologic disorders. Comprehensive Therapy 21: 8084.Google ScholarPubMed
Delahunty, J. E. (1972) Acid laryngitis. Journal of Laryngology and Otology 86: 335342.CrossRefGoogle ScholarPubMed
Delahunty, J. E., Cherry, J. (1968) Experimentally produced vocal cord granulomas. Laryngoscope 78: 19411947.CrossRefGoogle ScholarPubMed
Fraser, A. G. (1994) Review article: gastro-oesophageal reflux and laryngeal symptoms. Alimentary Pharmacological Therapeutics 8: 265272.CrossRefGoogle ScholarPubMed
Frieldberg, J. (1990) Hoarseness. In Pediatric Otolaryngology, 2nd Edition. Vol. 1 (Bluestone, C. D., Stool, S. E., Scheetz, M. D., eds.). W.B. Saunders Company, Philadelphia, PA pp 10901097.Google Scholar
Galmiche, J. P., Scarpignato, C. (1994) Esophageal pH Monitoring. In Functional Investigations of Esophageal Disease. Frontiers of Gastrointestinal Research Vol. 22 (Galmiche, J. P., Scarpignato, C, eds.). Karger, Basel, pp 71108.Google Scholar
Heymans, H. S. A. (1996) Current recommendations for the management of gastro-oesophageal reflux in children. In Les medicaments du RGO et de Vinfection a helicobacter pylori chez I'enfant. (Pons, G., Dupont, C, eds.). Springer-Verlag, Paris, pp 7585.Google Scholar
Kambic, V., Radel, Z. (1984) Acid posterior laryngitis: aetiology, histology, diagnosis and treatment. Journal of Laryngology and Otology 98: 12371240.CrossRefGoogle ScholarPubMed
Kamel, P. L., Hanson, D., Kahrilas, P. J. (1994) Omeprazole for the treatment of posterior laryngitis. American Journal of Medicine 96: 321326.CrossRefGoogle ScholarPubMed
Katz, P. O. (1990) Ambulatory esophageal and hypopharyngeal pH monitoring in patients with hoarseness. American Journal of Gastroenterology 85: 3840.Google ScholarPubMed
Kennedy, J. H. (1962) ‘Silent’ gastroesophageal reflux in children: an important but little known cause of pulmonary complications. Diseases of the Chest 42: 4245.CrossRefGoogle Scholar
Koufman, J. A. (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD). Laryngoscope (Suppl 53) 101: 178.CrossRefGoogle ScholarPubMed
McNally, P. R., Maydonovitch, C. L., Prosek, R. A., Collette, R. P., Wong, R. K. H. (1989) Evaluation of gastroesophageal reflux as a cause of idiopathic hoarseness. Digestive Diseases and Science 34: 19001904.CrossRefGoogle ScholarPubMed
Putnam, P. E., Orenstein, S. R. (1992) Hoarseness in a child with gastroesophageal reflux. Ada Paediatrica 81: 635636.CrossRefGoogle Scholar
Raymond, J., Kalach, N., Bergeret, M., Barbet, J. P., Benhamou, P. H., Gendrel, D., Dupont, C. (1996) Evaluation of a serological test for the diagnosis of Helicobacter pylori infection in children. European Journal of Clinical Microbiology and Infectious Diseases 15: 415417.CrossRefGoogle ScholarPubMed
Sandu, B. K., Surendra-Kumar, D., Martin, P. B. (1996) Methods of evaluation of gastro-oesophageal reflux in children. In Les médicaments du RGO et de I'infection à helicobacter pylori chez I'enfant. (Pons, G., Dupont, C, eds.). Springer-Verlag, Paris, pp 1121.Google Scholar
Weiner, G. M., Batch, A. J. G., Radford, K. (1995) Dysphonia as an atypical presentation of gastro-oesophageal reflux. Journal of Laryngology and Otology 109: 11951196.CrossRefGoogle ScholarPubMed
Wiener, G. J., Koufman, J. A., Wu, W., Cooper, J. B., Richter, J. E., Castell, D. O. (1989) Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-hour ambulatory pH monitoring. American Journal of Gastroenterology 84: 15031508.Google Scholar