Lower airway anomalies in infants with laryngomalacia

In most cases, laryngomalacia presents as a mild disease, and the symptoms resolve after wait-and-see policy. Up to 20 % of patients present with severe laryngomalacia and may require surgery (i.e. supraglottoplasty); however, the indication for surgery is not firmly established yet. The goal of this study is to determine whether supraglottoplasty results in a better outcome than wait-and-see and to investigate how different comorbidities influence outcome. A retrospective study of pediatric cases of in a tertiary referral center was performed. Photo and video documentation was available and revised in all cases. Electronic and paper charts were reviewed for the following variables: gender, sex, gestational age, birth weight, symptoms, comorbidity, date of endoscopy, severity and type of laryngomalacia, treatment modality and technique and follow-up data and a total 89 patients were included. Supraglottoplasty was found to lead to significantly faster complete improvement of laryngomalacia than wait-and-see policy (5 weeks vs. 29, p = 0.026). Synchronous airway lesions (SALs) were present in 40.4 % of patients and were associated with prolonged symptoms of laryngomalacia (38.5 weeks vs. 14.5, p = 0.043). Supraglottoplasty is safe and effective in treatment of severe laryngomalacia. SALs and comorbidities are frequently found in patients with laryngomalacia and are responsible for longer onset of complaints.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-016-3943-3) contains supplementary material, which is available to authorized users.

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“…The most common reported SAL in our cohort is tracheamalacia (39 %). This is in agreement with other studies [ 7 , 22 ].…”

Section: Discussionsupporting

confidence: 94%

Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia

Heijden

Dikkers

Halmos

2016

Eur Arch Otorhinolaryngol

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“…All the associated foregut malformations noted in our cohort have been previously noted in other research. Airway malacias (laryngomalacia, tracheomalacia, bronchomalacia) coincided: (1) with one another [42], (2) with esophageal atresia and tracheoesophageal fistula [43], and (3) with congenital diaphragmatic hernia [44]. We also observed esophageal atresia with tracheoesophageal fistula frequently as expected from previous reports [45], and annular pancreas in 18% of the eleven duodenal atresia patients [39,46].…”

Section: Discussionsupporting

confidence: 87%

Cincinnati Regional Incidence, Morbidity, and Mortality of Neonatal Foregut Defects and High Coincidence with Cardiovascular Malformations

Kenny¹,

Tabangin²,

Hall³

et al. 2013

J Neonatal Biol

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“…The need to perform fiberobronchoscopy instead of laryngoscopy as a method to evaluate SAL is a matter of discussion among experts. Some authors [7, 9, 11–13] accept the advantage of FB, while others [6, 10] suggest that patients with SAL will manifest the severity of this condition with clinical symptoms, urging the clinicians to perform complete airway examination anyway [6, 8]. …”

Section: Discussionmentioning

confidence: 99%

Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions

Kusak

Cichocka‐Jarosz

Jedynak-Wąsowicz

et al. 2016

Eur Arch Otorhinolaryngol

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The aim of this study was to: (1) find out whether laryngomalacia (LM) types are related to clinical course; (2) which patients with LM are at higher risk of other airway malacia [tracheomalacia (TM) and/or bronchomalacia (BM)]; and (3) evaluate the prevalence of LM in our region. Patients with established LM diagnosis and complete clinical and endoscopy records were enrolled. They were classified into different LM types according to classification based on the side of supraglottic obstruction. One hundred ten children were included. The most common LM appearance was type I-58 children, followed by combine types (I ? II and I ? III)-38. The other airway malacia were found in 47 patients: TM in 31, BM in 10, and TM with BM in 6. Other comorbidities (cardiac, neurological, and genetic disorders) were identified in 30 children. Patients with combine types of LM differ from those with single type of LM in terms of prematurity (13 vs 31 %, p = 0.04) and higher weight on the examination day (p = 0.006). Patients with other airway malacia differ from children with isolated LM in terms of prematurity (40 vs 13 %, p = 0.008), comorbidities (38 vs 19 %, p = 0.024), and lower weight on the examination day (p = 0.014). The prevalence of clinically relevant LM was one in 2600-3100 newborns. Clinical course of LM cannot be anticipated on the basis of solely endoscopic evaluation of the larynx. Comorbidities and prematurity increase the risk of other airway malacia. The prevalence of LM is relatively high in the middle-south part of Poland.

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Lower airway anomalies in infants with laryngomalacia

Abstract: Infants with moderate and severe laryngomalacia should be evaluated with flexible fibreoptic bronchoscopy to rule out associated lower airway lesions.

Cited by 14 publications

References 14 publications

Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia

Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia

Cincinnati Regional Incidence, Morbidity, and Mortality of Neonatal Foregut Defects and High Coincidence with Cardiovascular Malformations

Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions

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