HOARSENESS AND GASTROESOPHAGEAL REFLUX IN CHILDREN

The importance of a hoarse voice or voice change in children has not b een stressed in the literature in the same way as it has been in adult s. We present 21 children who had been suffering from chronic hoarsene ss for more than three months and had on fibre-optic laryngoscopy find ings suggestive of gastroesophageal reflux. None of them had complaine d of gastroesophageal symptoms. Twenty-four hour pH monitoring reveale d that 13 (62 per cent) of these children had gastroesophageal reflux, seven (33 per cent) having gastroesophageal reflux more than three ti mes the upper limit of normal. The pH graphs highlighted frequent refl uxes, ranging from 0.4 to 37.4 refluxes per hour (median of 7.3 reflux es/hour). The majority of these refluxes occurred when the child was a wake as opposed to asleep, with a median of 14.8 refluxes/hour and 0.9 refluxes/hour respectively (p = 0.0009). The refluxes were classicall y of short duration. This study suggests that gastroesophageal reflux plays a direct role in the pathogenesis of chronic laryngitis and hoar seness in children.