The effect of aryepiglottoplasty for laryngomalacia on gastro-oesophageal reflux.
OBJECTIVE
to investigate whether relief of airway obstruction in laryngomalacia by aryepiglottoplasty affects gastro-oesophageal reflux.


METHODS
a prospective study of consecutive infants and children with suspected laryngomalacia. Gastro-oesophageal reflux was measured before and after diagnostic microlaryngobronchoscopy and aryepiglottoplasty.


RESULTS
of the six cases who underwent aryepiglottoplasty and completed the study, three had significant pre-operative reflux according to age. In this group the reflux improved significantly after aryepiglottoplasty. In the other three cases, reflux was not age-significant pre-operatively nor did it change significantly post-operatively.


CONCLUSIONS
when partial airway obstruction due to laryngomalacia co-exists with gastro-oesophageal reflux, treatment of the airway problem improves respiratory symptoms in all cases and reduces gastro-oesophageal reflux in patients with age-significant reflux. This suggests that there are two clinical groups, those with severe, age-significant reflux, possibly caused by airway obstruction, whose gastro-oesophageal reflux benefits from aryepiglottoplasty; and those whose reflux is physiological and not influenced by aryepiglottoplasty. Therefore aryepiglottoplasty can be expected to reduce gastro-oesophageal reflux in those infants with laryngomalacia who have age-significant reflux.
Hadfield
Pandora J
PJ
Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.
Albert
David M
DM
Bailey
C Martin
CM
Lindley
Keith
K
Pierro
Agostino
A
D000402:Airway Obstruction / Q000209:etiology*; D004825:Epiglottis / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012135:Respiratory Sounds / Q000209:etiology; D012720:Severity of Illness Index