Transient pharyngonasal reflux is relatively common in neonates and during the first 3 months of life.
Pathological pharyngonasal reflux may be associated with:
(1) frequent apneic episodes
(2) prematurity
(3) neuromuscular disorders (dysautonomia, myopathy)
(4) velopharyngeal incoordination or palatoesophageal dyskinesia
(5) disorders of the soft palate (surgical, congenital, tumor)
(6) cleft palate
The reflux can be demonstrated on imaging studies by demonstrating the passage of contrast medium from the pharynx into the nasopharynx and nares.
The evaluation of a patient with a cleft palate may try to distinguish between reflux through the pharynx from leakage through the defect in the oropharynx. A palate obturator may be used to occlude the defect in the hard palate.
Complications or associated findings:
(1) otitis if fluid enters the middle ear
(2) difficulty with feedings
(3) aspiration pneumonia
