Laryngeal Anatomic Differences in Pediatric Patients With Severe Laryngomalacia

Manning, Scott C.; Inglis, Andrew F.; Mouzakes, Jason; Carron, Jeffrey D.; Perkins, Jonathan A.

doi:10.1001/archotol.131.4.340

Cited by 50 publications

(35 citation statements)

References 17 publications

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“…To date, the pathophysiology of laryngomalacia is still not fully understood and several factors may contribute to the disease [6,8]. Several anatomic changes of the supraglottis are observed in laryngomalacia [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…It is characterized by a dynamic obstruction of the upper airway due to an inward collapse of supraglottic structures during inspiration. Although several theories have been postulated [2][3][4][5][6][7], the exact etiology of laryngomalacia is not fully understood and different factors may contribute to the disease [6,8], notably gastroesophageal reflux [9][10]. Laryngomalacia typically presents with a moderate to high-pitched fluttering inspiratory stridor being more marked during increased air demands.…”

Section: Introductionmentioning

confidence: 99%

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Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Escher

Probst

Gysin

2015

Journal of Pediatric Surgery

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BACKGROUND/IMPORTANCE: Supraglottoplasty is the surgical procedure of choice for severe laryngomalacia and has shown to be successful in most cases; however, patients with medical comorbidities present a higher rate of failure. To date, the best management of laryngomalacia in children with congenital syndrome remains unclear. PURPOSE: To study the outcome of supraglottoplasty in children with severe laryngomalacia, and to analyze the management and outcome in infants with a congenital syndrome. METHODS: Retrospective medical records review from January 2003 to October 2012 of all patients who underwent laser supraglottoplasty for severe laryngomalacia at the University Children's Hospital Zurich, Switzerland. RESULTS: Thirty-one patients were included; median age at time of surgery was 3.5 months. Three patients (10%) had a genetically proven congenital syndrome with associated neurologic anomalies. Overall success rate was 87%. Failures were observed in four (13%) of 31 cases; including all three patients presenting a congenital syndrome. CONCLUSIONS: Supraglottoplasty is an effective and safe treatment for laryngomalacia in otherwise healthy children. Signs of a possible underlying predominant neurologic origin and discrepancy between the clinical presentation and the endoscopic findings have to be taken into account, as in children with congenital syndrome with neurologic anomalies the risk of failure is higher.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Escher

Probst

Gysin

2015

Journal of Pediatric Surgery

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“…Laryngomalacia and reflux may also be associated because both may represent effects of general low muscle tone in the upper aerodigestive tract. As reported by Manning et al [11], 18 of 24 patients with severe laryngomalacia had a diagnosis of GER, although only 6 of the 18 had undergone a contrast study or pH probe.…”

Section: Laryngopharyngeal Manifestationsmentioning

confidence: 72%

ENT manifestations of gastroesophageal reflux

Passàli

Caruso²,

Passàli

2008

Curr Allergy Asthma Rep

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Gastroesophageal reflux (GER) has been associated with a variety of supraesophageal symptoms or diseases, including chronic cough, laryngeal disorders, rhinosinusitis, otitis media, and oral cavity lesions. In this article, we review the relationship between GER and ear, nose, and throat (ENT) symptoms. Data in the published literature are frequently conflicting. Only a few studies are controlled, and an evidence-based approach provides weak support for a causal association between GER and ENT manifestations. The GER diagnostic method should be standardized utilizing new parameters, and the definition and diagnostic accuracy of ENT pathologies also must be better specified. A firm connection remains controversial, and further randomized trials are needed.

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“…Although the cause of this collapse may be attributed to the short aryepiglottic folds, anatomical factors such as the structure of the epiglottis, and easily flexible characteristics of immature cartilage tissues, the widely accepted cause currently is the neurological theory (1)(2)(3)(4)(5). It is suggested that decreased laryngeal tonus associated with sensorimotor dysfunction and particularly elevated thresholds of the laryngeal adductor reflex lead to the development of laryngomalacia (2,6,7).…”

Section: Introductionmentioning

confidence: 99%

Laryngomalacia: Our Clinical Experience

Olgun

Özay

Çakır

et al. 2017

Turk Arch Otorhinolaryngol

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Objective: The aim of this study is to analyse the clinical symptoms, follow-up and treatment properties of the laryngomalacia patients that we encountered between 2009 and 2014. Methods:Records of 81 laryngomalacia patients who were followed up in our clinic between 2009 and 2014 were retrospectively analysed. Patients' gender, age, time of onset of the symptoms, chief complaints, other co-existing congenital laryngeal anomalies and treatment and follow-up properties were evaluated. Results:Of the 81 patients, 48 were male and 33 were female, and the mean age was 4.9 months. The average period of follow-up was 12.1 months. The chief complaints at the time of admission were stridor (100%) and episodic cyanosis with feeding (27.16%). Symptoms of 75 patients were resolved at an average of 8.2 months with conservative treatment. Three patients underwent supraglottoplasty. Tracheotomy and posterior cordotomy was performed for a patient with co-existing vocal cord paralysis. Additional tracheotomy was necessary for a patient with pulmonary co-morbidities and for another with co-existing subglottic stenosis. Conclusion:Laryngomalacia is the most common cause of stridor in infants. The majority of laryngomalacia patients can be managed conservatively by close follow-up. For patients in whom respiratory and feeding problems persist or growth retardation develops, surgical treatment is performed. Tracheotomy may be necessary for a small group of patients with additional diseases.

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Laryngeal Anatomic Differences in Pediatric Patients With Severe Laryngomalacia

Cited by 50 publications

References 17 publications

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

Management of laryngomalacia in children with congenital syndrome: The role of supraglottoplasty

ENT manifestations of gastroesophageal reflux

Laryngomalacia: Our Clinical Experience

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