Presentation of a treatment concept in pediatric multiple laryngeal malformation

Introduction Congenital laryngeal deformities of the newborn child always require an individual treatment concept.

Case Report We report on a child with a congenital laryngeal malformation. On the 4th day of life the presentation in our clinic took place for the first time consultative by the children's ICU. The main symptoms were a stridor and a dyspnea, the crying was aphonic. In flexible videolaryngoscopy, a glottis web (Cohen grade IV) with a plump, rigid, hypoplastic, and tight larynx was seen. Thyroid and cricoid cartilage were interconnected en bloc. On the 8th day of life, the web was separated and tracheotomy was carried out. To avoid a recurrence of the web, on the 13th day of life, we established a glottal splinting with a nasogastric tube. At the age of 23 months, we performed the reconstruction of the vocal folds with placing a stent as well as the transcutaneous split of the thyroid and cricoid cartilage with interposition of a cartilage chip. A laryngeal reconstruction and dilatation took place at 27 months. At the age of 2; 11 years, the patient underwent tracheostomy closure.

Conclusion Congenital laryngeal malformations require an interdisciplinary cooperation. In addition to pediatric intensive care, surgical treatment by an experienced surgeon is important. Because producing sufficient respiratory/ vocal function is a particular challenge, multiple surgical procedures in infancy are often required. A pedaudiological co-treatment with a speech therapy is important. The long-term connection to a specialized laryngological center is required, even for possibly necessary corrective surgery.

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Artikel online veröffentlicht:
10. Juni 2020