There is a high association between GERD and laryngomalacia. All babies reflux, but children with laryngomalacia may have more than other babies. Acid reflux, if it reaches the upper portion of the swallowing tube (esophagus) and voice box region, can cause additional swelling of the floppy tissue seen in LM.
The pH probe is a test where a small tube is placed through the nose of the baby and into the esophagus. The tube is connected to a measuring device that records the number of times acid leaves the stomach and reaches the esophagus. This test will measure the acid in two places in the esophagus, just before the stomach and near the throat. Placement of the tube is usually done while taking an X-ray so that it can accurately measure acid in these two places. Your baby will need to stay in the hospital overnight for this test. Your doctor may recommend this test if he / she is concerned about the degree of acid regurgitation (vomiting or spitting up) your baby may be having.
Microlaryngoscopy and Bronchoscopy
This test is done in the operating room under general anesthesia by the ENT surgeon. The doctor looks at the voice box and windpipe with telescopes. Your doctor may recommend this test if the X-ray test shows something abnormal or if your doctor has a suspicion of additional airway problems.
An EGD is a diagnostic test done in the operating room under general anesthesia by the gastroenterologist. The doctor looks at your child's esophagus and stomach with a lighted tube.
During an EGD, the doctor looks for signs of chronic inflammation from acid irritation that can occur in the stomach or the esophagus. Your doctor may recommend this if the pH probe is significantly abnormal or there is strong suspicion of significant GERD based on history and clinical examination.