AAO-HNSF: Recurrent Croup Should Trigger Reflux Evaluation

September 22, 2008

A number of factors are associated with recurrent croup, notably laryngopharyngeal reflux and subglottic stenosis, according to a study presented at the American Academy of Otolaryngology - Head and Neck Surgery Foundation Annual Meeting and OTO EXPO held from Sept. 21 to 24 in Chicago.

MONDAY, Sept. 22 (HealthDay News) -- A number of factors are associated with recurrent croup, notably laryngopharyngeal reflux and subglottic stenosis, according to a study presented at the American Academy of Otolaryngology - Head and Neck Surgery Foundation Annual Meeting and OTO EXPO held from Sept. 21 to 24 in Chicago.

Harlan R. Muntz, M.D., and Ryan Clark Vanwoerkom, M.D., conducted a study of 80 children diagnosed with recurrent croup who underwent endoscopy to try to identify the underlying pathology that made them prone to recurrent episodes of the disease.

There were 26 children (33 percent) with subglottic stenosis, with an average 32 percent narrowing; 19 of these children (73 percent) also had laryngopharyngeal reflux, the researchers found. Among the 15 children (19 percent) who had undergone intubation as neonates or infants, eight (53 percent) had subglottic stenosis, the investigators report. Laryngopharyngeal reflux was diagnosed by laryngotracheal findings or other testing in 45 (56 percent) of the cases and 26 (58 percent) of them had concomitant subglottic stenosis, while 31 (39 percent) of the children had allergies or asthma, 16 (20 percent) had tracheomalacia and seven (9 percent) had innominate artery compression. It was common for children to have multiple risk factors, the researchers note.

"This study will assist the clinician in discussion of possible etiologies with families and insurers. Defining underlying pathology can then assist in the defining treatment options," the authors write.

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