Congenital Laryngeal Stridor (Inspiratory Laryngeal Collapse) a New Theory as to Its Underlying Cause and the Desirability of a Change in Terminology

Schwartz, Leo S.

doi:10.1001/archotol.1944.00680010418003

Cited by 35 publications

(13 citation statements)

References 12 publications

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“…These newer laser adaptations afford increased precision while reducing heat, char and edema. With these techniques, our results mirrored other reported studies [4]. Our study showed a success rate of 86% (19/22).…”

Section: Discussionsupporting

confidence: 91%

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Role of transoral CO2 laser surgery for severe pediatric laryngomalacia

Gandhi

Oswal

Thekedar

et al. 2011

Eur Arch Otorhinolaryngol

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Controversy exists as to the preferred treatment modality for managing refractory pediatric laryngomalacia (LM). Simultaneous bilateral procedures have been associated with supraglottic stenosis. Unilateral operations have a higher rate of secondary intervention. This prospective study was conceptualized to ascertain a preferred approach. A secondary goal was to correlate the surgical outcome with presenting symptoms and signs. Twenty-two children with severe LM met the criteria for enrollment. Bilateral CO(2) laser-assisted supraglottic laryngoplasties were performed in all cases. The procedure mainly consisted of division of the aryepiglottic fold. Nineteen (86%) patients met our defined success criteria. There were no surgical complications. Bilateral supraglottic laryngoplasty has a role in the management of severe refractory LM.

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Section: Discussionsupporting

confidence: 91%

“…Iglauer [3] first described the surgical alteration of supraglottis in laryngomalacia. Schwartz [4] removed a V-shaped wedge from the epiglottis with encouraging results. Studies from France in 1971 and 1984 described hypomandibulopexy as a surgical procedure [5,6].…”

Section: Introductionmentioning

confidence: 99%

Role of transoral CO2 laser surgery for severe pediatric laryngomalacia

Gandhi

Oswal

Thekedar

et al. 2011

Eur Arch Otorhinolaryngol

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“…Occasionally it may be noticed only on exertion.1 Rarely, it is both inspirato¬ ry and expiratory9 although some state that laryngomalacia is never expiratory. 16 The stridor is made worse by any¬ thing that increases respiration, including crying, nursing, agitation, excitement, activity, or struggling.6' 7·9·10·16' 17 Stridor is also aggra¬ vated by upper respiratory tract infections during which time there is an increased risk of aspiration.1 Expi¬ ratory actions such as crying or coughing are normal in laryngomala¬ cia.91014 Stridor is also affected by positioning, increased by supination and head flexion, and decreased by pronation and head extension.2·6·7 Reports of stridor during sleep are variable11012 with it decreasing proba¬ bly because of quiet respiration or pronation of the patient and increas¬ ing probably because of supination. 18 patients with laryngomalacia by laryngoscopy.…”

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confidence: 99%

Laryngomalacia: A Review and Case Report of Surgical Treatment With Resolution of Pectus Excavatum

Lane¹,

Weider²,

Steinem³

et al. 1984

Archives of Otolaryngology - Head and Neck Surgery

113

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\s=b\ Laryngomalacia has been described in the medical literature for over 100 years. During this time many different names have been used for the same condition. There have been numerous discussions of symptoms, cause, pathogenesis, relationships to other conditions, hereditary factors, and treatment. The purpose of this study is to historically review the literature, clarify terminology, and describe the clinical aspects of the disease.We also summarize and make conclusions regarding cause, pathogenesis, genetic and disease relationships, prognosis, and treatment. Finally, we present a case report of severe laryngomalacia and describe a surgical technique used to treat it. (Arch Otolaryngol 1984;110:546-551) Iaryngomal aci a is described as an infantile inspiratory stridor, present at birth or within the perina¬ tal period. The stridor increases in

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“…Em 1928, Hasslinger relatou excelentes resultados na ressecção das pregas ariepiglóticas de três pacientes com laringomalacia 9 . Schwartz, em 1944, 10 propôs que a laringomalacia grave poderia ser tratada através da ressecção cirúrgica dos bordos laterais da epiglote. Entretanto, foi somente em 1984 que Lane et al 11 , pela primeira vez, propuseram que a laringomalacia grave deveria ser tratada através da ressecção endoscópica da mucosa redundante de uma ou de ambas as aritenóides, e de ressecção das bordas laterais da epiglote.…”

Section: Discussionunclassified

Supraglotoplastia endoscópica em crianças com laringomalacia grave com e sem doença neurológica associada

Fraga¹,

Schopf²,

Volker³

et al. 2001

J. Pediatr. (Rio J.)

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ResumoObjetivos: descrever as indicações e resultados da supraglotoplastia endoscópica em crianças com e sem lesão neurológica que apresentavam laringomalacia grave.Métodos: estudo retrospectivo de 8 crianças com laringomalacia grave submetidas a supraglotoplastia endoscópica com material de microcirurgia. Quatro crianças tinham paralisia cerebral (todas masculinas, idade média 6 anos) e 4 eram crianças sem doença neurológica (3 femininas, idade média de 11,5 meses). As indicações da cirurgia foram dificuldade respiratória em repouso e/ou esforço, dificuldade de deglutição, deficiência de crescimento e baixa saturação transcutânea de oxigênio. Estudo polissonográfico realizado nas últimas duas crianças mostrou dessaturação na oximetria, apnéia e hipoventilação durante o sono. As crianças receberam corticóide e antibiótico no pré-operatório.Resultados: todas as crianças sem doença neurológica apresentaram melhora significativa do estridor e da obstrução ventilatória. Das crianças com paralisia cerebral, uma necessitou traqueostomia logo após a cirurgia por edema e tecido de granulação supraglótico. As outras três apresentaram melhora clínica inicial, mas pioraram progressivamente, apesar da realização de outros procedimentos: uma necessitou nova supraglotoplastia após 6 meses; outra necessitou traqueostomia após 7 meses. Aquelas sem traqueostomia persistem com obstrução ventilatória grave. Não foi observada complicação do procedimento cirúrgico.Conclusões: 1) a supraglotoplastia é bem tolerada e sem complicações na criança; 2) a supraglotoplastia, neste estudo, mostrouse eficaz no tratamento da laringomalacia grave em crianças sem paralisia cerebral; entretanto, a supraglotoplastia não melhorou a obstrução ventilatória de crianças com paralisia cerebral e laringomalacia grave. AbstractObjective: to describe indications and results of supraglottoplasty for severe laryngomalacia in children with or without neurological impairment.Methods: eight children with severe laryngomalacia submitted to endoscopic supraglottoplasty were retrospectively studied. Four had neurological impairment (male, mean age 6 years), and 4 did not present neurological problems (3 female, mean age 11.5 months). Surgery indications were respiratory distress, feeding difficulties, failure to thrive, and low oxygen saturation. Polysomnographic evaluation was carried out on the last 2 children, showing abnormal oxygen saturation, obstructive apnea, and hypoventilation. All children received preoperative antibiotics and corticosteroids.Results: all children without neurological impairment had significant relief of symptoms. Children with neurological impairment had different outcome: one needed tracheotomy immediately after surgery due to edema and supraglottic granulation tissue. The other three children presented initial relief of symptoms, but subsequent follow-up showed progressive airway obstruction: one needed another endoscopic surgery 6 months later; other needed tracheotomy 7 months later. The children who were not submitted to tracheos...

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Congenital Laryngeal Stridor (Inspiratory Laryngeal Collapse) a New Theory as to Its Underlying Cause and the Desirability of a Change in Terminology

Cited by 35 publications

References 12 publications

Role of transoral CO2 laser surgery for severe pediatric laryngomalacia

Role of transoral CO2 laser surgery for severe pediatric laryngomalacia

Laryngomalacia: A Review and Case Report of Surgical Treatment With Resolution of Pectus Excavatum

Supraglotoplastia endoscópica em crianças com laringomalacia grave com e sem doença neurológica associada

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