CC BY-NC-ND 4.0 · Laryngorhinootologie 2019; 98(S 02): S163
DOI: 10.1055/s-0039-1686580
Abstracts
Pediatric ENT

Different laryngeal dimensions and proportions in normal pediatric larynxes and laryngomalacia

L Nikiforova
1   Department of Neurosurgery and ENT Diseases, Medical University of Varna, Varna, Bulgaria
,
N Sapundzhiev
1   Department of Neurosurgery and ENT Diseases, Medical University of Varna, Varna, Bulgaria
,
G Stoyanov
2   Department of General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, Bulgaria
,
I Valkadinov
3   Medical University of Varna, Varna, Bulgaria
,
V Platikanov
4   Department of Anaesthesiology, Emergency, Intensive Medicine, Medical University of Varna, Varna, Bulgaria
› Author Affiliations
› Further Information
Also available at
 
 

    The dynamic endoscopic picture of severe laryngomalacia (LM) is distinctive, but the criteria for differentiation between normal anatomy, borderline conditions and LM have not been established yet. Our aim is to evaluate morphometric endoscopic criteria of the larynxes in newborns and toddlers with LM and without noticeable laryngeal pathology.

    Infants and toddlers subjected to general anesthesia with intubation for other reasons were included. During routine laryngoscopy for intubation endoscopic pictures and video sequences were recorded in an uniform manner. A total of 24 patients (20 with normal anatomy; 4 with LM) were evaluated A Macintosh laryngoscope with a raster scale attached to the blade was used. In each case, the raster was captured both with the larynx (subsequently serving as a measurement unit) and separately with the optical system mounted on a stand (distortion correction template). After correction of the barrel distortion of selected images and contouring of the supraglottic and glottic floor, analysis of 4 laryngeal proportions and 11 dimensions was performed.

    The antero-posterior/transverse supraglottic diameter ratio is 1,47 ± 0,74 in norm and 2,56 ± 0,53 in LM. The epiglottic edge width/epiglottic intlet ratio is < 1 (0,44 ± 0,13) in norm and > 1 (1,18 ± 0,19) in LM. The epiglottic inlet/transverse supraglottic diameter ratio is 0,43 ± 0,11 in norm and 0,26 ± 0,05 in LM.

    In LM the antero-posterior supraglottic diameter is longer, the inlet of the epiglottis is thinner than its upper edge width and relatively thinner than the transverse supraglottic diameter in comparison to the normal larynx. In LM the supraglottis has specific static proportions, which may serve as diagnostic criteria for LM during routine laryngoscopy in apnea.


    #
    Lora Nikiforova
    Department of Neurosurgery and ENT Diseases, Medical University of Varna,
    Marin Drinov Str. 55, 9002
    Varna, Bulgaria

    Publication History

    Publication Date:
    23 April 2019 (online)

    © 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

    Georg Thieme Verlag KG
    Stuttgart · New York