Abnormal oral mucosal light reflectance in infantile hypertrophic pyloric stenosis.
OBJECTIVE
Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring surgical intervention during the first weeks of life. The etiology of IHPS is unknown, although both neuronal nitric oxide synthase upregulation and an extracellular matrix abnormality are suspected. Familial predisposition is an important feature. Phenotypical markers of IHPS, such as hypoplasia or agenesis of the inferior labial frenulum, have been described. The authors tested the hypothesis that IHPS is associated with abnormal reflectance of the oral mucosa.


METHODS
Twenty-five children with surgically confirmed IHPS and 25 gender- and age-matched control subjects participated in the study. Reflectance of the lower gingival and vestibular oral mucosa in the optical spectrum was measured using an imaging spectrophotometer.


RESULTS
Patients with IHPS had significantly higher light reflectance values in the violet, blue, blue-green, green, yellow, and orange sections of the spectrum (all P values < 0.0001), with a maximum distance between group means at the 450-nm wavelength (t-value: 27.66, df = 48). A reflectance cutoff >5.26% at the 450-nm wavelength identified patients with IHPS with 100% sensitivity and 100% specificity.


CONCLUSIONS
This study reports a previously unrecognized mucosal reflectance abnormality of the oral mucosa in IHPS, thus offering a new, accurate, and noninvasive phenotypic marker for the condition.
Parrini
Stefano
S
Department of Odontostomatologic Sciences, University of Siena, Siena, Italy.
Di Maggio
Giovanni
G
Latini
Giuseppe
G
Bianciardi
Giorgio
G
Valdambrini
Laura
L
De Felice
Claudio
C
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D002675:Child, Preschool; D005109:Extracellular Matrix / Q000473:pathology; D005260:Female; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008027:Light; D008297:Male; D009061:Mouth Mucosa / Q000473:pathology*; D010781:Photography; D046248:Pyloric Stenosis, Hypertrophic / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013053:Spectrophotometry / Q000379:methods