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The role of the otolaryngologist in the evaluation and diagnosis of eosinophilic esophagitis
Author(s) -
Kubik Mark,
Thottam Prasad,
Shaffer Amber,
Choi Sukgi
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26373
Subject(s) - eosinophilic esophagitis , otorhinolaryngology , medicine , eosinophilic , dermatology , gastroenterology , general surgery , pathology , surgery , disease
Objective To describe the clinical presentation and role of the otolaryngologist in the evaluation of eosinophilic esophagitis (EoE) at a tertiary pediatric hospital. Study Design Retrospective review. Methods Records from pediatric patients with a diagnosis of EoE from 2003 to 2015 were reviewed. Study variables were analyzed to compare patients presenting to different specialties. Results Two hundred and fifty‐one patients with EoE were evaluated. The median age at diagnosis was 9.0 years (range 0.8–19.0); 73% were male. Sixty‐seven percent of patients initially presented to gastroenterology and 18% to otolaryngology. Time from initial presentation to diagnosis did not differ between the patients presenting to the two specialties (median 2.3 vs. 2.0 months, P = 0.510). Overall, 26% presented with airway symptoms (stridor, chronic cough, croup, or dysphonia). Patients diagnosed by the otolaryngology service were younger (3.4 vs. 10.4 years, P < 0.0001), had a higher incidence of airway symptoms (68% vs. 15%, P < 0.001), and demonstrated fewer gastrointestinal symptoms (86% vs. 100%, P < 0.001). Conclusion Patients with EoE frequently present to otolaryngology undiagnosed in the first 5 years of life, making esophagoscopy with biopsy an important adjunct to airway endoscopy in children with refractory aerodigestive symptoms. Otolaryngologists are uniquely poised to facilitate early diagnosis and initiation of therapy for these children, potentially reducing long‐term sequelae. Level of Evidence 4. Laryngoscope , 127:1459–1464, 2017