The prevalence of gastroesophageal reflux in children with tracheomalacia and laryngomalacia

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 prob lems who were between the ages of 3 and 28 months were investigated. All of them underwent flexible bronchoscopy and chest radiography. Eighteen child ren had laryngomalacia, 13 had tracheomalacia, and 23 had combined laryngot racheomalacia. During bronchoscopy, BAL was performed. An analysis of macro phages in the BAL fluid for lipid content was performed. Fifty-four childre n with laryngomalacia and tracheomalacia constituted the study group, and 6 2 children were in the control group. Reflux studies were obtained for 40 c hildren 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). I n the control group, GER was found mainly among those with recurrent bilate ral pneumonia. The lipid-laden macrophage score was correlated with the doc umented GER. Conclusion: GER is prevalent among infants with large airways malacia, and treatment of this group with antireflux therapy should be considered.