Objective: We conducted a retrospective study to
determine the relationship between gastroesophageal reflux (GER) and
large airways malacia in infancy.
Methods: One hundred
sixteen children referred for chronic respiratory problems who were
between the ages of 3 and 28 months were investigated. All of them
underwent flexible bronchoscopy and chest radiography. Eighteen
children had laryngomalacia, 13 had tracheomalacia, and 23 had combined
laryngotracheomalacia. During bronchoscopy, BAL was performed. An
analysis of macrophages in the BAL fluid for lipid content was
performed. Fifty-four children with laryngomalacia and tracheomalacia
constituted the study group, and 62 children were in the control group.
Reflux studies were obtained for 40 children from the study group and
41 from the control group.
Results: In the study
group, 28 children (70%) had GER documented by reflux studies compared
with 16 children (39%) in the control group (p < 0.01). In the
control group, GER was found mainly among those with recurrent
bilateral pneumonia. The lipid-laden macrophage score was correlated
with the documented GER.
Conclusion: GER is prevalent
among infants with large airways malacia, and treatment of this group
with antireflux therapy should be considered.