PROXIMAL PH-METRY FOR DIAGNOSIS OF UPPER AIRWAY COMPLICATIONS OF GASTROESOPHAGEAL REFLUX

Otolaryngologic complications of gastroesophageal reflux (GER) are wel l described in adults, but this relationship has not been as carefully studied in children. We reviewed 26 dual pH-probe studies performed o n 22 children with upper airway symptoms. The proximal probe was place d in the nasopharynx or hypopharynx. The distal probe was placed in th e mid-proximal oesophagus. The proximal recording was considered norma l if no episodes of pH < 4 were recorded. Indications for the studies were upper airway obstruction (UAO) and congenital choanal atresia (CC A). The age range was from 2 weeks to 47 months. The distal pH probe s tudy was normal in 13 of 22 patients overall. Seventeen UAO patients h ad abnormal proximal pH probe studies. After treatment, 16 of 17 had i mproved airways. Twelve with UAO (67%) were premature and/or had devel opmental delay. Three CCA patients had abnormal proximal pH-probe stud ies and all improved after treatment. Four followup pH studies were no rmal or improved. GER-induced UAO is more frequent in infants or child ren with a history of prematurity or developmental delay. Proximal pH- metry is a useful technique to document the relationship between upper airway symptoms and GER. Patients with GER-induced UAO should undergo endoscopy to rule out simultaneous airway lesions.