The Role of Awake Trans Nasal Esophagoscopy in Diagnosis of GERD in Infants with Laryngomalacia

Abstract
Background: Laryngomalacia is the most common con-genital anomaly causing stridor in infants.
Aim of Study: Was to evaluate Egyptian infants having laryngomalacia and presenting with feeding difficulties to assess the role of awake trans nasal esophagoscopy in diagnosis of GERD and compare the laryngoscopic and esophagoscopic findings in those with failure to thrive to those without failure to thrive to ascertain if severity of the symptoms in those infants influences the laryngeal picture and the esophageal function.
Patients and Methods: The study was conducted on 56 infants at the feeding and swallowing disorders clinic at the Phoniatric Unit, Cairo University Hospitals. They were selected from those who presented with inspiratory stridor and one or more symptoms of feeding difficulties. They were divided into Laryngomalacia cases with FTT and another group of laryngomalacia cases without FTT. History taking, laryngo-scopic and awake trans-nasal esophagoscopic assessments were carried out for the two groups.
Results: Revealed that infants with FTT showed significant difference in some symptoms of feeding difficulties than those without FTT. There was non significant difference between the two groups regarding the laryngoscopic and the esophago-scopic findings.
Conclusion: Laryngoscopic findings don't change with the laryngomalacia severity. Laryngomalacia cases with feeding difficulties should be evaluated by both laryngoscopy and awake trans-nasal esophagoscopy.