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

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.

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.