The Assessment of Congenital Laryngeal Lesions in Infants with Stridor
Year 2024,
, 118 - 123, 15.08.2024
Fulya Özer
,
Cem Özer
,
Fatma Caylakli
,
Alper Nabi Erkan
Abstract
Objective: In neonatal stridor, various conditions can be responsible as well as laryngomalacia. These conditions can be quite rare and the treatment of these diseases could be complicated. The purpose of this study is to identify the laryngeal pathologies and to discuss our approach in infants with chronic stridor.
Methods: The hospital charts of infants with stridor undergoing rigid laryngotracheobronchoscopy in our hospital in 2018-2022 were retrospectively reviewed.
Results: 107 children were enrolled to the study. The most frequent diagnosis was laryngomalacia (isolated and seen with secondary airway lesions (SALs)) (74 patients, 69.1%). 10 patients (9.3 %) had subglottic stenosis which caused stridor or dyspnea. Regarding other laryngeal lesions, in 8 patients (7.47 %) the diagnosis was laryngeal edema and 8 patients (7.47 %) had tracheomalacia. SALs which occurred with laryngomalacia were seen in 16 patients of our series (14.9 % of all cases). Surgery was performed in 11 of patients. Stridor was resolved in % 80 of laryngomalacia patients at about 2 years of age with only follow up.
Conclusions: In neonatal stridor, various conditions can be responsible as well as laryngomalacia. Referral of infant to otorhinolaryngologists and examination with flexible and rigid endoscopy is necessary for the assessment of stridor. The examination of the airway with the rigid endoscopy under general anesthesia without intubation on operating room with the cooperation of the anesthesiologist may provide the surgical intervention together with simultaneous inspection especially in the patients with severe stridor and systemic diseases.
Supporting Institution
This study was approved by Baskent University Institutional Review Board (Project no:KA19/412) and supported by Baskent University Research Fund.
References
- Hassan MM, Emam AM, Mahmoud AM, Awad AH, Rezk I, Abou-Taleb A, et al. Congenital laryngomalacia: Is it an inflammatory disease? The role of vitamin D. Laryngoscope. 2019; Apr 11. doi: 10.1002/lary.27997. google scholar
- Sakakura K, Chikamatsu K, Toyoda M, Kaai M, Yasuoka Y, Furuya N. Congenital laryngeal anomalies presenting as chronic stridor: A retrospective study of 55 patients. AurisNasus Larynx, 2008; 35: 527-33. doi: 10.1016/j.anl.2007.12.001. google scholar
- Valentino WL, Lafferty D, Manteghi A. An Interesting Secondary Airway Lesion in an Infant With Laryngomalacia. Ear Nose Throat J. 2021 Mar;100(3):NP156-NP157. doi: 10.1177/0145561319872729. Epub 2019 Sep 24. google scholar
- Cooper T, Benoit M, Erickson B, El-Hakim H. Primary Presentations of Laryngomalacia. JAMA Otolaryngol Head Neck Surg. 2014 Jun;140(6):521-6. doi: 10.1001/jamaoto.2014.626. google scholar
- Rifai HA, Benoit M, El-Hakim H. Secondary airway lesions in laryngomalacia: a different perspective. Otolaryngol Head Neck Surg. 2011 Feb;144(2):268-73. doi: 10.1177/0194599810391600. Epub 2010 Dec 29. google scholar
- Thompson DM. Laryngomalacia: factors that influence disease severity and outcomes of management. Curr Opin Otolaryngol Head Neck Surg. 2010 Dec;18(6):564-70. doi: 10.1097/ MOO.0b013e3283405e48. google scholar
- Clark CM, Kugler K, Carr MM. Common causes of congenital stridor in infants. JAAPA. 2018 Nov;31(11):36-40. doi: 10.1097/01. JAA.0000546480.64441.af. google scholar
- Erdem E, Gokdemir Y, Unal F, Ersu R, Karadag B, Karakoc F. Flexible bronchoscopy as a valuable tool in the evaluation of infants with stridor. Eur Arch Otorhinolaryngol. 2013 Jan;270(1):21-5. doi: 10.1007/s00405-012-2057-9. Epub 2012 May 26. google scholar
- Lee AJ, Prager JD, Mandler TN, Chatterjee D, Wine TM, Janosy NR. Anesthesia for laryngotracheal reconstruction in children: A narrative review. Paediatr Anaesth. 2023 Nov;33(11):883-893. doi: 10.1111/pan.14716. Epub 2023 Jul 6. google scholar
- Cotton RT. Management of subglottic stenosis. The Otolaryngologic Clinics of North Am. 2000; 33(1); 111-129. doi: 10.1016/s0030-6665(05)70210-3 google scholar
- Krashin E, Ben-Ari J, Springer C, Derowe A, Avital A, Sivan Y. Synchronous airway lesions in laryngomalacia. Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):501-7. doi: 10.1016/j. ijporl.2008.01.002. Epub 2008 Mar 4. PMID: 18291536. google scholar
- Bhatt J, Prager JD. Neonatal Stridor: Diagnosis and Management. Clin Perinatol. 2018 Dec;45(4):817-831. doi: 10.1016/j. clp.2018.07.015. Epub 2018 Sep 24. PMID: 30396420. google scholar
- Rangachari V, Aggarwal R, Jain A, Kapoor MC. Neonatal airway lesions: our experience and a review of the literature. J Laryngol Otol. 2013 Jan;127(1):80-3. doi: 10.1017/S002221511200254X. Epub 2012 Nov 21. PMID: 23171623. google scholar
- Martins RH, Dias NH, Castilho EC, Trindade SH. Endoscopic findings in children with stridor. Braz J Otorhinolaryngol. 2006 Sep-Oct;72(5):649-53. doi: 10.1016/s1808-8694(15)31021-1. PMID: 17221057; PMCID: PMC9443551. google scholar
- Aksoy EA, Elsürer C, Serin GM, Unal OF. Evaluation of pediatric subglottic cysts. Int J Pediatr Otorhinolaryngol. 2012 Feb;76(2):240-3. doi: 10.1016/j.ijporl.2011.11.012. Epub 2011 Dec 14. PMID: 22172219. google scholar
- Li Y, Irace AL, Dombrowski ND, Perez-Atayde AR, Robson CD, Rahbar R. Vallecular cyst in the pediatric population: Evaluation and management. Int J Pediatr Otorhinolaryngol. 2018 Oct;113:198-203. doi: 10.1016/j.ijporl.2018.07.040. Epub 2018 Jul 25. PMID: 30173985. google scholar
- Nisa L, Holtz F, Sandu K. Paralyzed neonatal larynx in adduction. Case series, systematic review and analysis. Int J Pediatr Otorhinolaryngol. 2013 Jan;77(1):13-8. doi: 10.1016/j. ijporl.2012.10.020. Epub 2012 Nov 17. PMID: 23164501. google scholar
- Adamczuk D, Krzemien G, Szmigielska A, Pierzchlewicz A, Roszkowska-Blaim M, Biejat A, Dşbska M, Jabtonska-Jesionowska M. Wrodzony stridor krtaniowy- problem interdyscyplinarny [Congenital laryngeal stridor-an interdisciplinary problem]. Med Wieku Rozwoj. 2013 Apr-Jun;17(2):174-8. Polish. PMID: 23988376. google scholar
- Asha’ari ZA, Abdullah F, Yusof S, Yusof RA. The yield of flexible airway endoscopy in infants and children with severe airway problems under a physician-surgeon combined-care setting: our experience from 121 procedures. Clin Otolaryngol. 2015 Feb;40(1):52-6. doi: 10.1111/coa.12328. PMID: 25311812. google scholar
Year 2024,
, 118 - 123, 15.08.2024
Fulya Özer
,
Cem Özer
,
Fatma Caylakli
,
Alper Nabi Erkan
References
- Hassan MM, Emam AM, Mahmoud AM, Awad AH, Rezk I, Abou-Taleb A, et al. Congenital laryngomalacia: Is it an inflammatory disease? The role of vitamin D. Laryngoscope. 2019; Apr 11. doi: 10.1002/lary.27997. google scholar
- Sakakura K, Chikamatsu K, Toyoda M, Kaai M, Yasuoka Y, Furuya N. Congenital laryngeal anomalies presenting as chronic stridor: A retrospective study of 55 patients. AurisNasus Larynx, 2008; 35: 527-33. doi: 10.1016/j.anl.2007.12.001. google scholar
- Valentino WL, Lafferty D, Manteghi A. An Interesting Secondary Airway Lesion in an Infant With Laryngomalacia. Ear Nose Throat J. 2021 Mar;100(3):NP156-NP157. doi: 10.1177/0145561319872729. Epub 2019 Sep 24. google scholar
- Cooper T, Benoit M, Erickson B, El-Hakim H. Primary Presentations of Laryngomalacia. JAMA Otolaryngol Head Neck Surg. 2014 Jun;140(6):521-6. doi: 10.1001/jamaoto.2014.626. google scholar
- Rifai HA, Benoit M, El-Hakim H. Secondary airway lesions in laryngomalacia: a different perspective. Otolaryngol Head Neck Surg. 2011 Feb;144(2):268-73. doi: 10.1177/0194599810391600. Epub 2010 Dec 29. google scholar
- Thompson DM. Laryngomalacia: factors that influence disease severity and outcomes of management. Curr Opin Otolaryngol Head Neck Surg. 2010 Dec;18(6):564-70. doi: 10.1097/ MOO.0b013e3283405e48. google scholar
- Clark CM, Kugler K, Carr MM. Common causes of congenital stridor in infants. JAAPA. 2018 Nov;31(11):36-40. doi: 10.1097/01. JAA.0000546480.64441.af. google scholar
- Erdem E, Gokdemir Y, Unal F, Ersu R, Karadag B, Karakoc F. Flexible bronchoscopy as a valuable tool in the evaluation of infants with stridor. Eur Arch Otorhinolaryngol. 2013 Jan;270(1):21-5. doi: 10.1007/s00405-012-2057-9. Epub 2012 May 26. google scholar
- Lee AJ, Prager JD, Mandler TN, Chatterjee D, Wine TM, Janosy NR. Anesthesia for laryngotracheal reconstruction in children: A narrative review. Paediatr Anaesth. 2023 Nov;33(11):883-893. doi: 10.1111/pan.14716. Epub 2023 Jul 6. google scholar
- Cotton RT. Management of subglottic stenosis. The Otolaryngologic Clinics of North Am. 2000; 33(1); 111-129. doi: 10.1016/s0030-6665(05)70210-3 google scholar
- Krashin E, Ben-Ari J, Springer C, Derowe A, Avital A, Sivan Y. Synchronous airway lesions in laryngomalacia. Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):501-7. doi: 10.1016/j. ijporl.2008.01.002. Epub 2008 Mar 4. PMID: 18291536. google scholar
- Bhatt J, Prager JD. Neonatal Stridor: Diagnosis and Management. Clin Perinatol. 2018 Dec;45(4):817-831. doi: 10.1016/j. clp.2018.07.015. Epub 2018 Sep 24. PMID: 30396420. google scholar
- Rangachari V, Aggarwal R, Jain A, Kapoor MC. Neonatal airway lesions: our experience and a review of the literature. J Laryngol Otol. 2013 Jan;127(1):80-3. doi: 10.1017/S002221511200254X. Epub 2012 Nov 21. PMID: 23171623. google scholar
- Martins RH, Dias NH, Castilho EC, Trindade SH. Endoscopic findings in children with stridor. Braz J Otorhinolaryngol. 2006 Sep-Oct;72(5):649-53. doi: 10.1016/s1808-8694(15)31021-1. PMID: 17221057; PMCID: PMC9443551. google scholar
- Aksoy EA, Elsürer C, Serin GM, Unal OF. Evaluation of pediatric subglottic cysts. Int J Pediatr Otorhinolaryngol. 2012 Feb;76(2):240-3. doi: 10.1016/j.ijporl.2011.11.012. Epub 2011 Dec 14. PMID: 22172219. google scholar
- Li Y, Irace AL, Dombrowski ND, Perez-Atayde AR, Robson CD, Rahbar R. Vallecular cyst in the pediatric population: Evaluation and management. Int J Pediatr Otorhinolaryngol. 2018 Oct;113:198-203. doi: 10.1016/j.ijporl.2018.07.040. Epub 2018 Jul 25. PMID: 30173985. google scholar
- Nisa L, Holtz F, Sandu K. Paralyzed neonatal larynx in adduction. Case series, systematic review and analysis. Int J Pediatr Otorhinolaryngol. 2013 Jan;77(1):13-8. doi: 10.1016/j. ijporl.2012.10.020. Epub 2012 Nov 17. PMID: 23164501. google scholar
- Adamczuk D, Krzemien G, Szmigielska A, Pierzchlewicz A, Roszkowska-Blaim M, Biejat A, Dşbska M, Jabtonska-Jesionowska M. Wrodzony stridor krtaniowy- problem interdyscyplinarny [Congenital laryngeal stridor-an interdisciplinary problem]. Med Wieku Rozwoj. 2013 Apr-Jun;17(2):174-8. Polish. PMID: 23988376. google scholar
- Asha’ari ZA, Abdullah F, Yusof S, Yusof RA. The yield of flexible airway endoscopy in infants and children with severe airway problems under a physician-surgeon combined-care setting: our experience from 121 procedures. Clin Otolaryngol. 2015 Feb;40(1):52-6. doi: 10.1111/coa.12328. PMID: 25311812. google scholar