Synchronous airway lesions and esophagitis in young patients undergoing adenoidectomy.
OBJECTIVE
To determine the prevalence of synchronous airway lesions and esophagitis in children younger than 18 months undergoing adenoidectomy for adenoid hypertrophy and upper airway obstruction.


METHODS
Retrospective review spanning 4.5 years.


METHODS
Tertiary care children's hospital.


METHODS
All children younger than 18 months who underwent adenoidectomy for upper airway obstruction by 2 pediatric otolaryngologists.


METHODS
craniofacial dysmorphism and congenital syndromes.


METHODS
Simultaneous interventions during adenoidectomy included flexible nasopharyngolaryngoscopy (n = 32), direct laryngoscopy (n = 31), rigid tracheobronchoscopy (n = 30), and esophagoscopy with biopsy (n = 32).


METHODS
Prevalence of synchronous airway lesions and histologic esophagitis.


RESULTS
Thirty-five children younger than 18 months underwent adenoidectomy for airway obstruction (2 also had simultaneous tonsillectomy). Synchronous airway lesions were found in 19 (59%) of 32 patients who underwent airway endoscopy, including laryngeal edema (n = 9), laryngomalacia (n = 8), tracheal vascular compression (n = 4), subglottic stenosis (n = 4), midmembranous vocal fold lesions (n = 3), bronchial stenosis (n = 1), and true vocal fold immobility (n = 1). Among 32 patients who underwent esophageal biopsy, histologic evidence of gastroesophageal reflux disease was found in 10 patients (31%), and eosinophilic esophagitis was found in 4 patients (13%). Overall prevalence of any synchronous finding (airway and/or esophagus) was 27 (77%) of 35.


CONCLUSIONS
Synchronous airway lesions and esophagitis (both gastroesophageal reflux disease and eosinophilic esophagitis) were prevalent among children younger than 18 months undergoing adenoidectomy for adenoid hypertrophy and upper airway obstruction. The presence of these findings argues for consideration of endoscopy during adenoidectomy for very young children.
Mandell
David L
DL
Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15213, USA.
Yellon
Robert F
RF
D000233:Adenoidectomy; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D007828:Laryngoscopy; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies