Endoscopic approach to laryngeal anomalies in infants and toddlers

Introduction:

Congenital anomalies of the larynx represent a large group of conditions characterized by respiratory distress in neonates and toddlers. The aim of the present study was to summarize our experience with the endoscopic evaluation and the therapeutic interventions in children with congenital stridor.

Methods:

A retrospective analysis of the cases of children under the age of 2 years, presenting with long term stridor as a leading symptom for the time period of 8 years (2010 – 2018) seen at a tertiary medical center in Bulgaria.

Results:

A total of 24 patients were enrolled – 18 (75%) boys, 6 (25%) girls 3.3 ± 4.9 months. The most common cause of stridor is laryngomalacia 11 (45.4%) followed by vocal cord paralysis 2 (8.3%), vallecular cyst 2 (8.3%), combined subglottic stenosis 1 (4.2%), subglottis hemangioma 1 (4.2%), an aberrant interatarinoid mucosal fold 1 (4.2%). The remaining two cases (8.3%) presented polymalformative conditions, which were hard to classify. Three cases of strior were found to be due to extralaryngeal causes: tracheal stenosis 3 (12.5%), tonsillar hypertrophy 1 (4.2%). Surgical treatment was performed in 16 patients (66.6%), including supraglottoplasty in 7 cases (44%).

Conclusion:

The endoscopy of the upper airways allows for easy and accurate diagnosis of the causes of a congenital stridor. Laryngomalacia is the most common cause. A significant proportion of patients may necessite early surgical treatment.

Publication History

Publication Date:
23 April 2019 (online)