Gastroesophageal reflux contributing to chronic sinus disease in children - A prospective analysis

Objective: To explore the possible role of gastroesophageal reflux (GER) in children with chronic sinus disease (CSD). Design: A descriptive prevalence study of the frequency of GER and nasopharyngeal reflux in children with CSD. Setting: Pediatric otolaryngology and gastroenterology outpatient clinics of a regional medical center. Patients and Other Participants: Consecutive children aged 2 to 18 years referred for evaluation of CSD from December 1, 1996, through April 30, 1998. Interventions: Participants underwent 24-hour monitoring with dual pH probes, and participants (or their parents) completed questionnaires before treatment and at specific intervals after treatment. Main Outcome Measures: Prevalence of GER and nasopharyngeal reflux in children with CSD, and the response of sinusitis to treatment in those diagnosed with GER. Results: Nineteen (63%) of 30 patients demonstrated esophageal reflux, which is well above the expected prevalence of GER in the healthy general population. Six (32%) of these 19 patients demonstrated nasopharyngeal reflux. Fifteen (79%) of 19 patients improved after treatment for GER. Conclusions: The children in this population had a prevalence of GER that was significantly higher than expected. Furthermore. most children with GER demonstrated improvement of sinus disease after treatment of GER. We recommend that children with CSD refractory to aggressive medical management be evaluated for GER and, if GER is present, be treated accordingly, before sinus surgery is considered.