Objective endoscopic findings in patients with recurrent croup: 10-year retrospective analysis

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• 作者：Benjamin L. Hodnett^a ; ^{benjamin.hodnett@uphs.upenn.edu" class="auth_mail" title="E-mail the corresponding author} ; Jeffrey P. Simons^b ; ¹ ; ^{jeffrey.simons@chp.edu" class="auth_mail" title="E-mail the corresponding author} ; Katherine M. Riera^c ; ² ; ^{katherine.m.riera@vanderbilt.edu" class="auth_mail" title="E-mail the corresponding author} ; Deepak K. Mehta^d ; ³ ; ^{dkmehta@texaschildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Raymond C. Maguire^e ; ^{maguirer2@upmc.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Recurrent croup ; Subglottic stenosis ; GERD ; LPR ; Bronchoscopy ; Esophagoscopy
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：79
• 期：12
• 页码：2343-2347
• 全文大小：276 K

文摘

(1) To determine the incidence and severity of subglottic stenosis on endoscopic evaluation in a pediatric population of patients with recurrent croup. (2) To determine the incidence of abnormal findings on bronchoalveolar lavage and esophageal biopsy in a pediatric population with recurrent croup.

Methods

Case series with historical chart review of clinical data for pediatric patients (age ≤18 years) at a tertiary care children's hospital who underwent endoscopic evaluation of the upper aerodigestive tract with a diagnosis of recurrent croup over a ten-year period (2002–2012). Subglottic stenosis was graded on Myer–Cotton scale. Lipid-laden macrophages on bronchoalveolar lavage were noted as none/small/moderate/large with evidence of reflux noted as moderate or large. Esophageal biopsy specimens were evaluated for evidence of esophagitis. Data is expressed as mean ± SEM.

Results

1825 charts were reviewed of which 197 met inclusion criteria. Mean age at endoscopy was 53 ± 3 months. Subglottic stenosis was noted in 41 patients (20.8%) with 95.1% being mild or Grade I. Abnormal findings on bronchoalveolar lavage were noted on 9.5% of bronchoalveolar lavage specimens. Abnormal esophageal biopsies were noted on 19.9% of specimens. Esophagitis was noted on 8.8% of biopsy specimens.

Conclusions

Subglottic stenosis is a risk factor for recurrent croup. Evidence suggestive of reflux may be noted on bronchoalveolar lavage or esophageal biopsy, but these findings may not correlate with subglottic stenosis in recurrent croup patients.