Laryngopharyngeal reflux and laryngeal web formation in patients with pediatric recurrent respiratory papillomas.
OBJECTIVE
To determine whether treatment of laryngopharyngeal reflux reduces the laryngeal soft tissue complications encountered in surgery for recurrent respiratory papillomas.


METHODS
Retrospective chart review.


METHODS
Retrospective chart review of all pediatric patients treated for laryngeal recurrent respiratory papillomas between 1984 and 1999 was performed. Thirty-one such patients were identified. Twenty-four were at "high risk" for developing complications based on the number of operating suite visits and the presence of disease at the anterior commissure. Twelve patients underwent 24-hour double pH probe testing.


RESULTS
Overall, 13 of 31 patients (42%) developed laryngeal webs. No other soft tissue complications were encountered. Of the patients who had pH probe testing, 12 of 12 (100%) had at least one pharyngeal episode of acid exposure. Of the "high-risk" patients, 10 were treated for reflux and only 2 of 10 (20%) developed webs. Eleven of 14 (79%) of the "high-risk" patients who were not treated for reflux developed webs. The difference in rate of web formation between patients treated for reflux and those not treated for reflux was statistically significant (P =.011).


CONCLUSIONS
Antireflux treatments for patients undergoing surgery for laryngeal recurrent respiratory papillomas may reduce the soft tissue complications, especially scarring and web formation. Prophylactic antireflux therapy may be warranted in any patient undergoing surgery during which laryngeal mucosal disruption is anticipated.
Holland
Bradford W
BW
Department of Otolaryngology-Head and Neck Surgery, Wake Forest University School of Medicine, Brenner Children's Hospital, Winston-Salem, North Carolina 27157-1034, USA.
Koufman
James A
JA
Postma
Gregory N
GN
McGuirt
William F
WF
D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007818:Laryngeal Diseases / Q000209:etiology* / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007830:Larynx / Q000473:pathology*; D008297:Male; D008365:Manometry; D010212:Papilloma / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies