Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckSurgical treatment for laryngomalacia
M. L. Zakharova (1), O. K. Gorkina (2), D. V. Breusenko (3), P. V. Pavlov (4), Sh. A. Karapetyan (5), Z. M. Orusmurzaeva (6)
(1), (2), (3), (4), (5), (6) Saint Petersburg State Pediatric Medical University, Saint Petersburg, 194100, Russian Federation
UDK: УДК 616.22-008.44053.1-089.843
DOI: https://doi.org/10.18692/1810-4800-2024-5-33-41
ABSTRACT
Abstract. Laryngomalacia is the most common congenital pathology of the larynx and the most common cause of congenital stridor in children. The main symptom of laryngomalacia is inspiratory stridor, which appears during the first 2 weeks after birth, can increase with physical or psychoemotional stress, and often stops on its own by the age of 2 years. The exact etiology of laryngomalacia is unclear. Diagnosis is based on transnasal flexible laryngoscopy without sedation. Laryngomalacia often manifests itself only as stridor breathing. However, in severe cases, this pathology can disrupt the physical and psychomotor development of the child and require surgical treatment in the amount of supraglottoplasty. Patients and research methods. The study included 196 children, including 116 (59.1%) boys and 80 (40.8%) girls. The patients were divided into 2 groups: the first (n = 167) with compensated laryngomalacia, the second (n = 29) with decompensated laryngomalacia. Children with decompensated laryngomalacia underwent supraglottoplasty. The effectiveness of surgical treatment was assessed by the reduction or relief of stridor, aspiration syndrome, obstructive sleep apnea syndrome, and the percentage of decannulated patients with a tracheostomy. Within 10 days after the surgery, the listed symptoms were relieved in all children. No complications were observed after 1–6–12 months. Conclusions. This study showed that laryngomalacia is more common in boys than in girls. Indications for supraglottoplasty in laryngomalacia types 1 and 2 are signs of upper respiratory tract obstruction, aspiration syndrome, faltering growth, respiratory decompensation due to respiratory infections, obstructive sleep apnea syndrome, and endoscopic signs of collapse of the laryngeal vestibule on inspiration. Supraglottoplasty is an effective method for treating the decompensated form of laryngomalacia.
Publication date:
17.10.2024
Keywords:
laryngomalacia, stridor, supraglottoplasty, tracheostomy, upper respiratory tract obstruction For citation:
Zakharova M. L., Gorkina O. K., Breusenko D. V., Pavlov P. V., Karapetyan Sh. A., Orusmurzaeva Z. M. Surgical treatment for laryngomalacia. Russian Otorhinolaryngology. 2024;23(5):33-41. (In Russ.) https://doi.org/10.18692/1810-4800-2024-5-33-41