Hoarseness in children: The role of laryngopharyngeal reflux

Objective: The rote of laryngopharyngeal reflux (LPR) in hoarseness in children is not well studied. The purpose of this study was to determine the prevalence of LPR in hoarse children. Methods: Retrospective chart review identified 337 children with hoarseness over a 3-year period. Data collected: mode of presentation, associated symptoms, endoscopic findings, laboratory testing, and therapeutic interventions and their outcomes. Results: Mean age at presentation was 7.2 +/- 4.3 years with a male:female ratio of 1.7:1. Of the 295/337 (88%) children who underwent endoscopy, 107/295 (36%) had LPR changes alone, 86/295 (29%) had vocal fold nodules, 63/295 (20%) had both LPR and vocal fold nodules; and 22/295 (7%) had a finding other than LPR or nodules. Of the children diagnosed with LPR by endoscopy (with or without nodules), 93/170 (55%) underwent at least one additional test for reflux with 69/93 (74%) having a positive test. Of the children diagnosed with LPR by endoscopy, neither cough nor throat clearing was identified in 82/170 (48%) of children. At the first follow-up visit, an average of 3 months from initial presentation, 50% of 169 children who were treated for reflux had improved or resolved. By the second follow-up visit, 4.5 months later, 68% of those children had improved or resolved. Conclusions: LPR appears to be a very common cause of hoarseness in children, and is an increasingly important symptom in identifying children with LPR. Treatment of LPR often results in improvement of hoarseness. 2007 Published by Elsevier Ireland Ltd.