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* From the Department of Pediatrics (Drs. Bibi, Khvolis, Ohaly, and Ater), the Department of Pathology (Dr. Ben Dor), and the Department of Radiology (Dr. London), Barzilai Medical Center, Ashkelon, Israel; and the Pediatric Respirology Unit (Dr. Shoseyov), Bikur Holim Hospital, Jerusalem, Israel.
Correspondence to: Haim Bibi, MD, Barzilai Medical Center, Ashkelon, Israel 78306
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.
Key Words: gastroesophageal reflux • laryngomalacia • tracheomalacia
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