Profiling the clinical characteristics and surgical efficacy of laryngomalacia in children.
Children
Inspiratory stridor
Laryngomalacia
Supraglottoplasty
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
02 Nov 2023
02 Nov 2023
Historique:
received:
30
04
2023
accepted:
17
09
2023
medline:
2
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
aheadofprint
Résumé
To analyze the clinical characteristics of laryngomalacia in Chinese children and explore the surgical efficacy and factors influencing severe laryngomalacia. Children (0-18 years) diagnosed with laryngomalacia in our hospital from January 2016 to January 2022 were enrolled in this study. Clinical data of patients, including general conditions, clinical symptoms, grading and classification, medical comorbidities, surgical efficacy, and the risk factors influencing severe laryngomalacia were retrospectively analyzed. A total of 1810 children were enrolled (male:female; 2.02:1), among which most were infants under 1 year (77.18%). Inspiratory laryngeal stridor (69.56%) was the most common symptom. Most patients had mild laryngomalacia (79.28%), with type IV laryngomalacia being the most common classification (52.27%). Congenital heart disease (37.85%) was the most common medical comorbidity. A total of 168 severe laryngomalacia cases were treated via supraglottoplasty with an effective rate of 83.93%. Notably, preterm birth (OR = 3.868, 95% CI 1.340 ~ 11.168), low birth weight (OR = 4.517, 95% CI 1.477 ~ 13.819) and medical comorbidities (OR = 7.219, 95% CI 2.534 ~ 20.564) were independent risk factors for poor prognosis (P < 0.05). Laryngomalacia is common among infants under the age of one, and it is mostly characterized by inspiratory laryngeal stridor with various medical comorbidity. Supraglottoplasty is the first treatment choice for severe laryngomalacia cases with high success rates. However, premature delivery, low birth weight, and medical comorbidities significantly affect the efficacy of surgery.
Identifiants
pubmed: 37914898
doi: 10.1007/s00405-023-08254-9
pii: 10.1007/s00405-023-08254-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Youth Innovation inFuture Medicine, Chongging Medical University
ID : W0128
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Jain D, Jain S (2022) Management of stridor in severe laryngomalacia: a review article. Cureus 14(9):e29585. https://doi.org/10.7759/cureus.29585
doi: 10.7759/cureus.29585
pubmed: 36320975
pmcid: 9597386
Pokharel A (2020) Prevalence of laryngomalacia among young children presenting with stridor in a tertiary care hospital. J Nepal Med Assoc. 58(230):712–716. https://doi.org/10.31729/jnma.5244
doi: 10.31729/jnma.5244
Rathi A, Rathi S (2016) Relative imbalance as etiology of laryngomalacia—a new theory. Med Hypotheses 98:38–41. https://doi.org/10.1016/j.mehy.2016.11.004
doi: 10.1016/j.mehy.2016.11.004
pubmed: 28012601
Munson PD, Saad AG, El-Jama SM, Dai Y, Bower CM, Richter GT (2011) Submucosal nerve hypertrophy in congenital laryngomalacia. Laryngoscope 121(3):627–629. https://doi.org/10.1002/lary.21360
doi: 10.1002/lary.21360
pubmed: 21344444
Hartl TT, Chadha NK (2012) A systematic review of laryngomalacia and acid reflux. Otolaryng Head Neck 147(4):619–626. https://doi.org/10.1177/0194599812452833
doi: 10.1177/0194599812452833
Ayari S, Aubertin G, Girschig H, Van Den Abbeele T, Mondain M (2012) Pathophysiology and diagnostic approach to laryngomalacia in infants. Eur Ann Otorhinolary 129(5):257–263. https://doi.org/10.1016/j.anorl.2012.03.005
doi: 10.1016/j.anorl.2012.03.005
Durvasula VS, Lawson BR, Bower CM, Richter GT (2014) Supraglottoplasty in premature infants with laryngomalacia: does gestation age at birth influence outcomes? Otolaryng Head Neck 150(2):292–299. https://doi.org/10.1177/0194599813514370
doi: 10.1177/0194599813514370
Edmondson NE, Bent JP, Chan C (2011) Laryngomalacia: the role of gender and ethnicity. Int J Pediatr Otorhi 75(12):1562–1564. https://doi.org/10.1016/j.ijporl.2011.09.008
doi: 10.1016/j.ijporl.2011.09.008
Cohen O, Picard E, Joseph L, Schwartz Y, Sichel JY, Attal P (2020) Supraglottoplasty for severe laryngomalacia. Can we predict success? Int J Pediatr Otorhi. 138:110333. https://doi.org/10.1016/j.ijporl.2020.110333
doi: 10.1016/j.ijporl.2020.110333
Carter J, Rahbar R, Brigger M, Chan K, Cheng A, Daniel SJ et al (2016) International pediatric ORL group (IPOG) laryngomalacia consensus recommendations. Int J Pediatr Otorhi. 86:256–261. https://doi.org/10.1016/j.ijporl.2016.04.007
doi: 10.1016/j.ijporl.2016.04.007
China Maternal and Child health association Minimally Invasive Chapter Pediatric ORL Group (2020) Clinical practice guidelines for the diagnosis and management of laryngomalacia in children. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 34(11):961–965. https://doi.org/10.13201/j.issn.2096-7993.2020.11.001
doi: 10.13201/j.issn.2096-7993.2020.11.001
Olney DR, Greinwald JH Jr, Smith RJ, Bauman NM (1999) Laryngomalacia and its treatment. Laryngoscope 109(11):1770–1775. https://doi.org/10.1097/00005537-199911000-00009
doi: 10.1097/00005537-199911000-00009
pubmed: 10569405
Toer F, Zuleika P, LA Adelien Y, Widyasari F (2022) Characteristics of laryngomalacia patients at department of otorhinolaryngology-head and neck surgery Dr. Mohammad Hoesin general hospital, Palembang, Indonesia Period 2021–2022. Oaijmr. 3(1):342–349. https://doi.org/10.37275/oaijmr.v3i1.273
doi: 10.37275/oaijmr.v3i1.273
Bhatta S, Gandhi S, Ganesuni D, Ghanpur A (2019) Associated airway anomalies and their impact in patients with laryngomalacia: a retrospective review. J Laryngol Voice 9(2):51–56. https://doi.org/10.4103/jlv.jlv_2_20
doi: 10.4103/jlv.jlv_2_20
Yusuf M, Utami P (2021) Laryngomalacia: diagnosis and management at otorhinolaryngology head and neck surgery department Dr. Soetomo Hospital Surabaya. Oto Rhino Laryn Indones. 50(2):129–134. https://doi.org/10.32637/orli.v50i2.405
doi: 10.32637/orli.v50i2.405
Liu Y, Wei P, Kou W, Hu S, Wu X, Liu M, Chen C, Yao H (2022) Analysis of clinical characteristics and surgical efficiency of severe laryngomalacia in children. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 36(4):258–264. https://doi.org/10.13201/j.issn.2096-7993.2022.04.004
doi: 10.13201/j.issn.2096-7993.2022.04.004
Vijayasekaran D, Balasubramanian S, Sivabalan S, Vindhiya K (2018) Clinical characteristics and associated congenital lesions with tracheomalacia in infants. Indian Pediatr 55(10):883–884
doi: 10.1007/s13312-018-1401-6
pubmed: 30426955
Glibbery N, Roplekar Bance R, Jonas N, Bewick J (2021) Synchronous airway lesions in children with severe, progressive and atypical laryngomalacia—experience of a UK tertiary referral centre. Int J Pediatr Otorhi 152:110984. https://doi.org/10.1016/j.ijporl.2021.110984
doi: 10.1016/j.ijporl.2021.110984
Simons JP, Greenberg LL, Mehta DK, Fabio A, Maguire RC, Mandell DL (2015) Laryngomalacia and swallowing function in children. Laryngoscope 126(2):478–484. https://doi.org/10.1002/lary.25440
doi: 10.1002/lary.25440
pubmed: 26152504
pmcid: 5064436
El-Kholy NA, Hashish MI, ElSobki AA (2019) Coagulation of the lateral surface of aryepiglottic folds as an alternative to aryepiglottic fold release in management of type 2 laryngomalacia. Auris Nasus Larynx 47(3):443–449. https://doi.org/10.1016/j.anl.2019.10.004
doi: 10.1016/j.anl.2019.10.004
pubmed: 31677853
Reinhard A, Gorostidi F, Leishman C, Monnier P, Sandu K (2016) Laser supraglottoplasty for laryngomalacia; a 14 year experience of a tertiary referral center. Eur Arch Oto-Rhino-L 274(1):367–374. https://doi.org/10.1007/s00405-016-4252-6
doi: 10.1007/s00405-016-4252-6
Sedaghat S, Fredes F, Tapia M (2017) Supraglottoplasty for laryngomalacia: the experience from Concepcion, Chile. Int J Pediatr Otorhi 103:113–116. https://doi.org/10.1016/j.ijporl.2017.10.012
doi: 10.1016/j.ijporl.2017.10.012
Thompson DM (2010) Laryngomalacia: factors that influence disease severity and outcomes of management. Curr Opin Otolaryngo 18(6):564–570. https://doi.org/10.1097/MOO.0b013e3283405e48
doi: 10.1097/MOO.0b013e3283405e48
Day KE, Discolo CM, Meier JD, Wolf BJ, Halstead LA, White DR (2011) Risk factors for supraglottoplasty failure. Otolaryng Head Neck 146(2):298–301. https://doi.org/10.1177/0194599811425652
doi: 10.1177/0194599811425652
El-Sobki A, Ibrahim RAE, Amer A, Hashish MI, El-Deeb ME, El-Kholy NA, Abdelmeguid AS (2021) Coblation supraglottoplasty: a ten-year experience in a tertiary referral hospital. Eur Arch Oto-Rhino-L 279(2):865–874. https://doi.org/10.1007/s00405-021-07130-8
doi: 10.1007/s00405-021-07130-8
Douglas CM, Shafi A, Higgins G, Wolf BJ, Halstead LA, White DR (2014) Risk factors for failure of supraglottoplasty. Int J Pediatr Otorhi 78(9):1485–1488. https://doi.org/10.1016/j.ijporl.2014.06.014
doi: 10.1016/j.ijporl.2014.06.014
Hoff SR, Schroeder JW, Rastatter JC, Holinger LD (2009) Supraglottoplasty outcomes in relation to age and comorbid conditions. Int J Pediatr Otorhi 74(3):245–249. https://doi.org/10.1016/j.ijporl.2009.11.012
doi: 10.1016/j.ijporl.2009.11.012