Surgical treatment of a case of adult epiglottic laryngomalacia

Bartolomeo, M.; Bigi, A.; Pelliccia, Pierfrancesco; Makeïeff, M.

doi:10.1016/j.anorl.2013.10.004

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…The importance of active glottal closure in prevention of aspiration is further supported by the well‐recognized risk of aspiration in dogs with laryngeal paralysis despite a normally functioning epiglottis . The human literature is mixed regarding the risk of aspiration after epiglottectomy . Abscessation of I‐EP occurred in 1 dog in our study after initial failed hyoepiglotticus imbrication and has not been reported as a complication in previous studies.…”

Section: Discussionsupporting

confidence: 58%

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Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

et al. 2019

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Objective To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs. Study design Multi‐institutional retrospective study. Sample population Fifty dogs treated with 78 procedures. Methods Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications. Results Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty‐six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114‐2805), 8 (16%) were lost to follow‐up after 411 days (range, 43‐1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3‐1212). Median survival time was not reached after a median of 716 days. Conclusion Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures. Clinical significance Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long‐term survival can be achieved.

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Section: Discussionsupporting

confidence: 58%

“…7 The human literature is mixed regarding the risk of aspiration after epiglottectomy. [8][9][10][11][12][13][14] Abscessation of I-EP occurred in 1 dog in our study after initial failed hyoepiglotticus imbrication and has not been reported as a complication in previous studies.…”

Section: Discussionmentioning

confidence: 87%

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

et al. 2019

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“…It is difficult to properly determine the volume of epiglottis to cut without causing postoperative sequelae. Bartolomeo et al [32] described their experiences with a 25-year-old man with laryngomalacia managed using CO2 laser V-shape partial epiglottectomy. The authors stated that this treatment minimizes the risk of false passage, while ensuring permanent respiratory airflow through the epiglottic V during epiglottic movement.…”

Section: Partial Epiglottectomymentioning

confidence: 99%

Epiglottic Collapse in Obstructive Sleep Apnea

Bae

Chung

2021

Sleep Med Res

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Along with the development of diagnostic techniques, many studies have been conducted to find the anatomical causes of obstructive sleep apnea (OSA). The velum, oropharynx, tongue base, and epiglottis have been widely considered to be the common obstruction sites. However, the role of the epiglottis in sleep apnea is poorly understood compared to the other anatomical sites. The epiglottis causes OSA either alone or simultaneously with other obstruction sites. We have here reviewed the epidemiology, pathophysiology, diagnosis, and treatment of epiglottic collapse in patients with OSA based on the literature published to date.

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“…Epiglotektomi parsial. 22 Whymark 6 melakukan epiglottopeksi pada 73% dari 58 bayi dengan LM derajat berat dimana didapatkan perbaikan stridor dan peningkatan berat badan pasien pasca operasi. Dilakukan ablasi mukosa lingual epiglotis dan mukosa pangkal lidah menggunakan laser CO2, kemudian epiglotis dan pangkal lidah dijahit menggunakan benang absorbable (gambar 9).…”

Section: Gambarunclassified

Diagnosis dan Penatalaksanaan Laringomalasia

Elfianto

Novialdi

2018

JKA

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AbstrakLatar belakang: Laringomalasia (LM) merupakan penyebab tersering stridor inspirasi kongenital pada bayi. Sekitar 80% kasus merupakan derajat ringan dan sedang yang dapat membaik serta resolusi sampai usia 2 tahun sedangkan 20% merupakan derajat berat yang membutuhkan tindakan pembedahan Tujuan: Mengetahui dan memahami etiologi, diagnosis dan penatalaksanaan laringomalasia. Tinjauan Pustaka: Diagnosis laringomalasia dapat ditegakkan dari anamnesis, pemeriksaan fisik serta pemeriksaan penunjang laringoskopi serat optic fleksibel. Etiologi pasti laringomalasia belum diketahui, namun terdapat 3 teori yang diduga berperan yaitu imaturitas kartilago, imaturitas neuromuskular dan abnormalitas anatomi. Terdapat hubungan antara laringomalasia dengan laryngopharyngeal reflux (LPR). Penatalaksanaan konservatif dilakukan pada LM derajat ringan dan sedang sedangkan tindakan pembedahan dilakukan pada derajat berat, laringomalasia dengan komorbid dan laringomalasia yang gagal terapi konservatif. Kesimpulan: Laringomalasia merupakan kolapsnya struktur supraglotis ketika inspirasi yang mengakibatkan adanya stridor inspirasi. Laringomalasia derajat berat dapat mengancam nyawa. Sebagian besar kasus akan resolusi sendiri, namun sekitar 20% memerlukan tindakan pembedahan. Supraglottoplasti merupakan tindakan pembedahan pilihan untuk kasus laringomalasia Kata kunci: Laringomalasia, stridor inspirasi, laringoskopi serat optik fleksibel, supraglottoplasti AbstractBackground : Laryngomalacia (LM) is the most common cause of inspiration stridor in infant. About 80% cases are mild and moderate that can improvement and resolution by 2 years of age, and aboout 20% cases is severe that need surgical intervention. Objective : Knowing and understanding etiology, diagnosis and management of laryngomalacia. Literature review :. Diagnosis of laryngomalacia is obtained from the history, phisical examination and supporting examination such as flexible fibreoptic laryngoscopy (FFL) . The etiology was unknown, but there are some theory that can explain cause of laryngomalacia such as cartilage immaturity, neuromuscular immaturity, an anatomic abnormality. There is corelation between laryngomalacia and laryngopharingeal reflux disease (LPR). Conservative treatment choosing for mild and moderate laryngomalacia and surgical intervention perform for severe laryngomalacia, laryngomalacia with comorbid disease and laryngomalacia which failed with conservative treatment. Conclusion : Laryngomalacia is a condition of supraglottic structure collaps into the airway during inspiratory phase that produce inspiration stridor and can make life threatening. Most of the cases are self limiting resolution, only about 20% need surgical intervention. Supraglottoplasty is the choice surgical procedure for laryngomalacia.

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Surgical treatment of a case of adult epiglottic laryngomalacia

Abstract: Excessive resection of the epiglottis may lead to false passage; insufficient resection risks being ineffective. V-shaped partial epiglottectomy minimizes risk of false passage while ensuring permanent respiratory airflow via the epiglottic V during epiglottic movement.

Cited by 8 publications

References 7 publications

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

Epiglottic Collapse in Obstructive Sleep Apnea

Diagnosis dan Penatalaksanaan Laringomalasia

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