title: Eosinophilic Laryngitis in Children with Aerodigestive Dysfunction.
abstract: OBJECTIVE
  To describe the presence of laryngeal eosinophils and associated symptomatology in patients with aerodigestive dysfunction.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Single tertiary pediatric referral center.
  
  
  METHODS
  Eighty-one consecutive pediatric patients referred to a multidisciplinary aerodigestive clinic with upper airway concerns.
  
  
  METHODS
  Microlaryngoscopy and posterior arytenoid biopsy, flexible bronchoscopy, esophagogastroduodenoscopy and esophageal biopsy, and impedance probe testing were performed as indicated by clinical symptoms. Positive versus negative posterior arytenoid biopsy for eosinophils and the presence or absence of concomitant histopathological laryngitis and/or esophagitis were measured.
  
  
  RESULTS
  Nine of 81 (11%) patients had positive laryngeal biopsy for eosinophils (range, 1-29 eosinophils/high-powered field [HPF]). Three of these 9 patients also had concurrent biopsy-proven eosinophilic esophagitis, while 8 of 81 total patients had biopsy-proven eosinophilic esophagitis. The frequency of biopsy-proven eosinophilic esophagitis was higher in patients with posterior arytenoid eosinophils versus patients without laryngeal eosinophils (33% versus 6.9%, P = .0408).
  
  
  CONCLUSIONS
  Eosinophilic inflammation in the larynx has not been described in children with complex aerodigestive complaints. Posterior arytenoid eosinophils may serve as a marker of chronic laryngeal inflammation in children with aerodigestive dysfunction, although their exact role in this inflammation remains unclear. In our population, >15 eosinophils/HPF within posterior arytenoid biopsies was associated with concomitant eosinophilic esophagitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Yawn
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt Children's Hospital, Nashville, Tennessee, USA.
authors.forename: Sari
authors.initials: S
authors.lastname: Acra
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Goudy
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Raina
authors.initials: R
authors.lastname: Flores
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA christopher.t.wootten@vanderbilt.edu.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Wootten
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004066:Digestive System Diseases / Q000150:complications* / Q000473:pathology; D004802:Eosinophilia / Q000453:epidemiology* / Q000473:pathology; D057765:Eosinophilic Esophagitis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007827:Laryngitis / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D012120:Respiration Disorders / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: adult; aerodigestive; airway; airway reconstruction; aspiration; dysphagia; dysphonia; eosinophilia; eosinophilic esophagitis; eosinophilic laryngitis; gastroesophageal reflux; inflammatory; laryngeal; laryngeal inflammation; laryngitis; larynx; pediatric; reflux; subglottic stenosis; voice