Reliability of the reflux finding score for infants in flexible versus rigid laryngoscopy

Singendonk, Maartje; Pullens, Bas; Heteren, Jan A. A. van; Gier, H. H. W. de; Hoeve, Hans; König, Astrid; Schroeff, Marc P. van der; Hoekstra, Carlijn; Veder, L.L.; Pol, Rachel J. van der; Benninga, Marc A.; Wijk, Michiel P. van

doi:10.1016/j.ijporl.2016.04.017

Cited by 13 publications

(4 citation statements)

References 16 publications

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“…This is particularly true in the pediatric population, where prior attempts to correlate laryngeal findings with reflux have failed. 15,16 We would agree that the tools of the otolaryngologist are not necessarily ideal for reflux evaluation in the pediatric population, but the decision to treat empirically is often influenced by parental concern for general anesthesia and more invasive diagnostic procedures, such as placement of a transnasal probe and esophageal biopsies. Officebased laryngoscopy is safe, brief, inexpensive, minimally invasive, well-tolerated, and readily available, making it an attractive tool for this purpose, and is viewed by many practicing pediatric otolaryngologist as adequate to guide therapeutic recommendations or further testing.…”

Section: See Related Article P 127mentioning

confidence: 99%

Questioning the Utility of Laryngoscopy in the Evaluation of Pediatric Gastroesophageal Reflux

Ida

Thompson

2017

The Journal of Pediatrics

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Section: See Related Article P 127mentioning

confidence: 99%

Questioning the Utility of Laryngoscopy in the Evaluation of Pediatric Gastroesophageal Reflux

Ida

Thompson

2017

The Journal of Pediatrics

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“…Laryngoscopy and polysomnography were performed only in a subgroup of infants when there were respiratory concerns about noisy breathing or apnea [43,44]. As previously reported by our group [74] and other authors [75,76], there was an inconsistent relationship between the different investigations in our population.…”

Section: Discussionmentioning

confidence: 70%

Study on Nocturnal Infant Crying Evaluation (NICE) and Reflux Disease (RED)

Carabelli,

Binotto,

Armano

et al. 2024

Children

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Background: Nocturnal infant crying is often empirically treated with acid suppressants. The aim of this study was to evaluate the prevalence and characteristics of gastroesophageal reflux (GER) in infants with unexplained persistent crying. Methods: We enrolled all infants (0–12 months) referred for suspected GER disease who underwent esophageal impedance–pH monitoring (MII-pH) for unexplained persistent crying not improved by parental reassurance, dietary modification or alginate. Gastrointestinal malformation/surgery, neurological impairment and infections were exclusion criteria. Demographic and anthropometric parameters, GER symptoms and questionnaires (I-GERQ-R) and MII-pH data were recorded and analyzed. Normal MII-pH was defined when acid exposure was <3%, symptom index was <50% and symptom association probability was <95%. Acid exposure >5% and >10% was also considered. Statistical analysis was performed using Chi-Square and univariate and multivariable regression analysis. Results: We included 50 infants (median age 3.5 months) who fulfilled the study criteria: 30 (60%) had normal MII-pH. I-GERQ-R score was abnormal in 33 (66%) infants, and 21/33 (64%) had normal MII-pH (p = 0.47). In the 26 (52%) infants with nocturnal crying, MII-pH was normal in 16 (54%) (p = 0.82). Associated regurgitation (>3 or >10 episodes/die) did not predict abnormal MII-pH (p = 0.74, p = 0.82, respectively). Univariate and multivariable regression analysis did not identify any clinical variable significantly associated with abnormal MII-pH. Conclusions: Infants with persistent unexplained and nocturnal crying should not be empirically treated with acid inhibitors.

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“…However, only moderate interobserver agreement was reached, with the highly variable intraobserver agreement [ 48 ]. Another recent study also supported the fact that the RFS-I is unsuitable for detecting signs of LPR in infants or guiding treatment, neither with flexible nor with rigid laryngoscopy [ 38 ]. Another attempt to create an assessment tool came from Baudoin et al in 2014.…”

Section: Resultsmentioning

confidence: 87%

Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?

Sofokleous

Παπαδοπούλου

Giotakis

et al. 2023

JCM

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Background: Laryngopharyngeal reflux may affect people of any age; still, most of the accumulated knowledge concerns adults, and evidence regarding pediatric populations remains relatively restricted. This study aims to review the most recent and emerging aspects of pediatric laryngopharyngeal reflux from the last ten years. It also attempts to identify gaps in knowledge and highlight discrepancies that future research should urgently address. Methods: An electronic search of the MEDLINE database was conducted, limited to January 2012 through December 2021. Non-English language articles, case reports, and studies that concerned a purely or predominantly adult population were excluded. The information from the articles with the most relevant contribution was initially categorized by theme and subsequently synthesized into a narrative form. Results: 86 articles were included, of which 27 were review articles, eight were surveys, and 51 were original articles. Our review systematically maps the research done in the last decade and provides an updated overview and the current state-of-the-art in this subject. Conclusions: Despite discrepancies and heterogeneity in accumulating research, evidence gathered so far endorses a need for refining an escalating multiparameter diagnostic approach. A step-wise therapeutic plan appears to be the most reasonable management approach, starting with behavioral changes for mild to moderate, uncomplicated cases and escalating to personalized pharmacotherapy options for severe or nonresponsive cases. Surgical options could be considered in the most severe cases when potentially life-threatening symptoms persist despite maximal medical therapy. Over the past decade, the amount of available evidence has been gradually increasing; however, its strength remains low. Several aspects remain markedly under-addressed, and further adequately powered, multicenter, controlled studies with uniformity in diagnostic procedures and criteria are urgently needed.

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Reliability of the reflux finding score for infants in flexible versus rigid laryngoscopy

Cited by 13 publications

References 16 publications

Questioning the Utility of Laryngoscopy in the Evaluation of Pediatric Gastroesophageal Reflux

Questioning the Utility of Laryngoscopy in the Evaluation of Pediatric Gastroesophageal Reflux

Study on Nocturnal Infant Crying Evaluation (NICE) and Reflux Disease (RED)

Pediatric Laryngopharyngeal Reflux in the Last Decade: What Is New and Where to Next?

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