ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Otolaryngologists Well-Positioned for Diagnosis, Treatment of Pediatric Patients with Eosinophilic Esophagitis

by Amy E. Hamaker • June 20, 2017

  • Tweet
  • Email
Print-Friendly Version

What are the clinical presentation and the role of the otolaryngologist in evaluating eosinophilic esophagitis (EoE) at a tertiary pediatric hospital?

Bottom line
Patients with EoE frequently present to otolaryngology undiagnosed in the first five years of life, making esophagoscopy with biopsy an important adjunct to airway endoscopy in children with refractory aerodigestive symptoms.

You Might Also Like

No related posts.

Explore This Issue
June 2017

Background: EoE diagnosis requires esophageal dysfunction symptoms, esophageal eosinophilia on esophageal biopsy, and exclusion of alternative causes of esophageal eosinophlia. Recently, there has been increased recognition of EoE as a cause of gastrointestinal morbidity and reduced quality of life in affected children, as well as EoE airway manifestations being a possible cause of recurrent croup, stridor, dysphonia, and chronic cough. As a consequence, the otolaryngologist’s role is evolving.

Study design: Retrospective review of 251 pediatric patients with an EoE diagnosis from 2003 to 2015.

Setting: Children’s Hospital of Pittsburgh, Pa.

Synopsis: Overall, 26% of patients presented initially with airway symptoms including chronic cough, dysphonia, stridor, or recurrent croup. Ninety-seven percent of patients had GI symptoms on presentation, the most common being dysphagia, recurrent emesis/nausea, and abdominal pain, or food regurgitation. Departmental sites of initial patient presentation were: gastroenterology 67%, otolaryngology 18%, allergy/immunology 3%, and emergency department 13%. Of patients initially evaluated by otolaryngology, 82% were diagnosed with eosphageal eosinophilia during diagnostic panendoscopy, while 18% were later diagnosed by the GI service. Median time to diagnosis did not depend on initial presentation site. Patients initially presenting to otolaryngology were significantly younger than those presenting to GI, and airway symptomatology was more common.

Common endoscopic abnormalities seen in patients with eosinophilic esophagitis. Credit: Copyright 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Common endoscopic abnormalities seen in patients with eosinophilic esophagitis.
Credit: Copyright 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Endoscopic esophagus appearance was normal in 17% of patients with pathologically confirmed esophageal esosinophilia; linear furrowing was the most common abnormality noted. Airway endoscopy was performed in 25% of the otolaryngology cohort; common findings included tracheal cobblestoning, laryngomalacia, and subglottic stenosis.

Ultimately, 14% of patients were diagnosed by otolaryngology on the basis of esophageal biopsy results during diagnostic panendoscopy. In only 18% of cases evaluated by otolaryngology was the diagnosis missed and subsequently made by GI.

Citation: Kubik M, Thottam P, Shaffer A, Choi S. The role of the otolaryngologist in the evaluation and diagnosis of eosinophilic esophagitis. Laryngoscope. 2017;127:1459–1464.

Filed Under: Literature Reviews, Pediatric Tagged With: diagnosis, endoscopy, eosinophilic esophagitis, esophagoscopy, otolaryngology, pediatrics, treatmentIssue: June 2017

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Complications for When Physicians Change a Maiden Name
    • How To: Inferior Meatus Augmentation Procedure for Empty Nose Syndrome
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • What Happens to Medical Students Who Don’t Match?
    • How To: Transseptal Approach to the Maxillary Sinus and Pterygopalatine Fossa
    • Patient Decision Aid Useful for Parents Offered Tonsillectomy for Their Children with Obstructive Sleep Apnea
    • Do Nimodipine and Steroids Influence Recovery Time in Post-Thyroidectomy Recurrent Laryngeal Nerve Paralysis?
    • Functional Results Strongly Influence Postoperative Satisfaction in Patients Who Have Undergone Rhinoplasty

Polls

Do you think training primary care doctors through otolaryngology fellowships will help curb the influx of unnecessary visits to specialists?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2022 The Triological Society. All Rights Reserved.
ISSN 1559-4939