Parents' Guide to Understanding and Managing Late -Onset Laryngomalacia in Infants (original) (raw)
Related papers
Archives of the Balkan Medical Union
La laryngomalacie du nourrisson La laryngomalacie est une maladie qui est la cause la plus fréquente d'étiologie chez le nourrisson et dans la plupart des cas, le patient se présente avec un stridor inspiratoire qui s'agrave pendant l'alimentation, les pleurs, la position couchée ou l'agitation. En laryngomalacie, les structures supraglottiques s'effondrent dans les voies respiratoires lors de l'inspiration, provoquant une obstruction des voies respiratoires. Généralement, les symptômes ne sont pas présents à la naissance mais apparaissent dans les 4 premiers mois de la vie et disparaissent à l'âge de 24 mois au maximum. Les symptômes associés les plus courants sont les troubles de la déglutition, la régurgitation, la toux et l'apnée du sommeil. La laryngomalacie est une maladie spontanément résolue, environ 20% des patients présentant une maladie grave et nécessitant un traitement chirurgical.
The maturation changes of sleep-related respiratory abnormalities in infants with laryngomalacia
Journal of Clinical Sleep Medicine
Study Objectives: Obstructive sleep apnea (OSA) and central sleep apnea (CSA) are common in infants with laryngomalacia. The purpose of this study was to evaluate developmental changes in sleep-related breathing disorders over time in infants with laryngomalacia and understand the effect of supraglottoplasty (SGP) and nonsurgical treatment. Methods: This is a retrospective review of infants with laryngomalacia who had at least 2 diagnostic polysomnography studies performed from January 2000 and May 2015. We included infants who had either OSA or CSA. Comparison of sleep and respiratory parameters by age group (0-6, 6-12, and >12 months old) was performed in both SGP and non-SGP groups using a mixed-effect regression model. A log-normal mixed model was used to explore the changes in sleep and respiratory parameters with age. The time to resolution of CSA and OSA was analyzed using nonparametric survival analysis. Results: A total of 102 infants were included; 57 had only OSA and 45 had both CSA and OSA. There were significant decreases in apnea-hypopnea index, obstructive index, central apnea index, and arousal index with increasing age in both SGP and non-SGP groups. The mean age at resolution of CSA (central apnea index < 5) was 7.60 months old for SGP and 12.57 months old for non-SGP (P <.05). There were no significant differences in the mean age at resolution of OSA (obstructive index < 1; 35.18 [SGP] vs 41.55 months [non-SGP]; P = .60) between SGP and non-SGP groups. Infants with neurologic disease, congenital anomalies, or genetic syndromes required significantly more time to resolve OSA (28.12 [normal] vs 53.13 [neurological] vs 59.53 months [congenital anomalies and genetic]; P < .01). Conclusions: Both OSA and CSA improve in infants with laryngomalacia with increasing age regardless of SGP. The mechanism underlying these changes may involve airway growth and maturation of respiratory control. Time to resolution of OSA is affected by the presence of neurologic diseases, congenital anomalies, and genetic syndromes. Further studies are needed to confirm these findings and to evaluate long-term outcomes in this population.
2021
Introduction: Brief resolved unexplained events (BRUE) occur during infancy. It is characterized by one or more symptoms, including skin color change, shortness of breath and unresponsiveness. Laryngomalacia is the most frequent cause of stridor in infants and results in the collapse of the supraglottic structures during inspiration and intermittent obstruction of the upper airways. To our knowledge, the relationship between BRUE and laryngomalacia has been little investigated. Methods: The medical records of 448 children (age < 12 months) treated for BRUE between July 2011 and March 2018 and followed up until March 2020 were retrospectively reviewed. Endoscopic evaluation was performed using a flexible fibrolaryngoscope. All patients underwent a brief polysomnography and 24-h cardiorespiratory monitoring. Cardiorespiratory and oxygen saturation monitoring was continued at home; 94% of patients underwent follow-up. Results: Laryngeal fiberoptic endoscopy revealed laryngomalacia i...
“LARYNGOMALACIA” EMBRYOLOGICAL BASIS AND ITS CLINICAL SIGNIFICANCE
Laryngomalacia is the most common cause of stridor in infants-strider results from upper airway obstruction due to supraglottic tissue collapse. Most causes of laryngomalacia are mild and self solve investigation and intervention required in severe causes. There is a strong association with gastroesophgeal reflux disease in patients with laryngomalacia and thus medical treatment with antireflux medications surgical treatment is preferred, while it indicate supraglottoplasty, severe cases are reserved. Proper identification of those patients when requires medical and surgical invention is key to providing with successful outcomes.
Laryngomalacia: Our Clinical Experience
Turk Otolarengoloji Arsivi/Turkish Archives of Otolaryngology, 2016
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.
Laryngomalacia: an atypical case and review of the literature
Ear, nose, & throat journal, 2004
Laryngomalacia is the most common cause of stridor in newborns and infants. Patients usually present with an inspiratory stridor only, although some exhibit other anomalies. To rule out other possible pathologies, bronchoscopy is advisable. However, the authors of some recent studies have advocated the use of fiberoptic laryngoscopy as a more cost-effective and less-invasive alternative. No surgical intervention is required to treat laryngomalacia in most cases. The disease usually resolves spontaneously by the time a patient reaches the age of 24 months. In this article, we describe a case of laryngomalacia that was atypical in that the patient was 10 years old. We also review the literature in an effort to increase awareness of this condition.
Survey of respiratory sounds in infants
Archives of Disease in Childhood, 2001
Background-Over the last decade there has been an apparent increase in childhood wheeze. We speculated that much of the reported increase may be attributed to the term wheeze being adopted by parents to describe a variety of other forms of noisy breathing.
Characteristics of Patients with Laryngomalacia: A Tertiary Referral Center Experience of 106 Cases
Diagnostics
Laryngomalacia (LM) is the most common airway congenital anomaly and the main cause of stridor in infants. Some patients with severe airway symptoms or with feeding difficulties require surgical intervention. Synchronous airway lesions (SALs) may influence the severity and course of the disease. This study aimed to determine the prevalence of various types of LM and SALs and their influence on surgical intervention decisions and feeding difficulties. Moreover, the study focused on the interrelations between SALs and the type of LM or the presence of feeding difficulties. A retrospective analysis of 106 pediatric patients revealed a significant relationship between type 2 LM and the necessity of surgical treatment. We also found a significant effect of LM type 2 on feeding difficulty. Type 1 LM is significantly more characteristic in premature children. Among different comorbidities, SALs are suspected of modification of the course and severity of LM. This study did not find a signif...