Pediatric Laryngeal Papillomatosis: Experiences at an Indian Teaching Hospital

Background: Vocal fold lesions are commonly found in the pediatric age group. The lesions of the vocal fold among children are variable. The laryngoscopic examination is needed for the identification of the vocal fold lesions. The objective of this study is to find out the different vocal fold lesions, clinical presentations, and diagnoses of the vocal fold lesions.Methods: The children aged from 5 to 18 years diagnosed with vocal fold lesions were included in this study. The study was conducted between June 2017 to July 2022. All the children with vocal fold lesions were subjected to video laryngoscopy for assessment of the larynx.Results: There were 156 children diagnosed with vocal fold lesions. The majority of this study's participants were male children (52.56%). The most common symptom was hoarseness. Most common vocal fold lesion was vocal fold nodule (43.58%). Voice abuse was the most common etiological factor behind the vocal fold lesions. Out of 156 children with vocal fold lesions, 72 children (46.15%) underwent microlaryngeal surgery under anesthesia. Voice therapy was given to all the children along with vocal hygiene care.Conclusions: Vocal fold lesions are often found among children. Dysphonia is the commonest clinical presentation of children with vocal fold lesions. Microlaryngeal surgery and voice therapy are two important options for the treatment of vocal fold lesions in pediatric patients.

Section: Discussionmentioning

confidence: 99%

Vocal fold lesions in the pediatric age group: our experiences at a tertiary care teaching hospital of India

Swain¹,

Dubey²

2022

“…In the past, the common indications were acute inflammatory airway obstruction like acute epiglottitis or diphtheria. 11 After the development of vaccines against Corynebacterium diphtheria and Haemophilus influenza as well as initiation of modern neonatal intensive care units have served to minimize the infection-based indications for tracheostomy. 12 Currently, upper airway obstruction due to laryngotracheal anomalies and prolonged ventilation are common indications of pediatric tracheostomy (Figure 2).…”

Section: Indications Of Pediatric Tracheostomymentioning

confidence: 99%

Pediatric tracheostomy: a review

Swain

2022

Tracheostomy is a life shaving surgery done in critically sick patients. Pediatric tracheostomy is a surgical procedure performed since ancient times. Performing tracheostomy in the pediatric age group is often challenging because of its association with morbidity and mortality. The indications for pediatric tracheostomy have been changed significantly in the last few decades. In pediatric patients, the common indications for tracheostomy are prolonged ventilation and upper airway obstruction. Advanced methods in pediatric anesthesia and increased awareness for vaccination for serious infections like measles, mumps, diphtheria, tetanus, and hemophilus influenza type b (Hib) among pediatric age increased the changing indications for performing tracheostomy from emergency to more elective one. There are numerous research papers available in medical literature for adult tracheostomy with its indications, surgical techniques, and complications, but literature for pediatric tracheostomy is scarce. This is always a requirement for standard guidelines for standard protocols for pediatric tracheostomy. Proper standardization of pediatric tracheostomy, timing, and appropriate indications are helpful to reduce the complications and mortality related to pediatric tracheostomy. Here, this review article is attempting to discuss the indications, preoperative evaluation, surgical techniques, complications, and post-operative care of the pediatric tracheostomy.

“…Predicting the difficult airway at the pediatric age requires adequate history, proper clinical examination, and reviewing the relevant investigation. 3 The airway of the pediatric age has a number of significant differences when compared to the adult age and presents some unique challenges. Awareness of the anatomical and physiological differences and important clinical conditions affecting the children will allow the clinicians to formulate and execute safe and effective management of the pediatric airway.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the pediatric airway: a review

Swain

2022

The airway in the pediatric age group is a complex structure that extends from the external nares to the junction of the larynx and trachea. The airway of pediatric patients has significant anatomical and physiological differences compared to the adult age group. The difficult airway in children is an important contributor to both morbidity and mortality of the patient. The symptoms and signs of pediatric patients with respiratory distress depend on the site and severity of the obstruction. It is essential to evaluate and localize the site and etiology of the obstruction of the pediatric airway. Pediatric otolaryngologists and anesthetists must have a strategy for managing the predicted difficult pediatric airway. Flexible nasopharyngolaryngoscopy is the gold standard method for predicting or knowing the difficult airway in children. The majority of pediatric patients who have difficult airways are identified preoperatively. Knowledge of the airway differences between the pediatric and adult ages will help clinicians anticipate and troubleshoot difficulties that may happen. This review article aims to discuss the evaluation of the pediatric airway including its anatomy and physiology of the airway, proper history taking, clinical examination, and investigations.