Congenital laryngomalacia: Is it an inflammatory disease? The role of vitamin D

Hassan, Megahed M.; Emam, Ahmed; Mahmoud, Ahmed M.; Awad, Al; Rezk, Ibrahim; Abou‐Taleb, Ashraf; Mohamed, Montasser; Elmagd, Essam

doi:10.1002/lary.27997

Cited by 8 publications

(9 citation statements)

References 29 publications

(60 reference statements)

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“…Children with laryngomalacia showed vitamin D deficiency and increased proinflammatory cytokine IL-6, which may result from dysregulation of the immune responses. Laryngomalacia could be an inflammatory disease secondary to maternal deficiency of 25(OH)-vitamin D with subsequent Vitamin D deficiency in exclusively breast-fed infants during neonatal and infantile periods [7].…”

Section: Etiologymentioning

confidence: 99%

Laryngomalacia

Waindeskar¹,

Thaware²,

Chamania³

et al. 2023

Updates on Laryngology

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Laryngomalacia is the most common cause of stridor in neonates and infants. In laryngomalacia, there is a supraglottic collapse of the larynx during inspiration leading to obstruction and thus resulting in stridor. The exact etiology of laryngomalacia is still unknown. The neurological basis is one of the leading theories explaining the etiology. Laryngomalacia in most of the patients resolves with conservative management by two years of age. In severe cases of laryngomalacia or when symptoms are persistent beyond two years of age, such cases need surgical management in the form of supraglottoplasty. Flexible fibreoptic laryngoscopy is the gold standard for the diagnosis of laryngomalacia. Various classifications have been proposed to classify laryngomalacia, although considering dynamic airway changes might be the most acceptable basis for classification. Supraglottoplasty has higher success and a low complication rate.

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Section: Etiologymentioning

confidence: 99%

Laryngomalacia

Waindeskar¹,

Thaware²,

Chamania³

et al. 2023

Updates on Laryngology

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“…In laryngomalacia, the stridor often worsens with feeding, and the infant need to take breaks while feeding to breathe. 44 The stridor in the case of mild laryngomalacia usually improves with crying, as the tone of the pharynx is increased; conversely, in case of moderate to severe laryngomalacia, the stridor typically worsens with crying due to increased airflow through the severely collapsed larynx. In the case of infants with severe laryngomalacia, infants have been found to have shorter aryepiglottic folds in comparison with infants without laryngomalacia.…”

Section: Laryngomalaciamentioning

confidence: 99%

Evaluation of the pediatric airway: a review

Swain

2022

Int J Contemp Pediatr

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The airway in the pediatric age group is a complex structure that extends from the external nares to the junction of the larynx and trachea. The airway of pediatric patients has significant anatomical and physiological differences compared to the adult age group. The difficult airway in children is an important contributor to both morbidity and mortality of the patient. The symptoms and signs of pediatric patients with respiratory distress depend on the site and severity of the obstruction. It is essential to evaluate and localize the site and etiology of the obstruction of the pediatric airway. Pediatric otolaryngologists and anesthetists must have a strategy for managing the predicted difficult pediatric airway. Flexible nasopharyngolaryngoscopy is the gold standard method for predicting or knowing the difficult airway in children. The majority of pediatric patients who have difficult airways are identified preoperatively. Knowledge of the airway differences between the pediatric and adult ages will help clinicians anticipate and troubleshoot difficulties that may happen. This review article aims to discuss the evaluation of the pediatric airway including its anatomy and physiology of the airway, proper history taking, clinical examination, and investigations.

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“…The severity of the respiratory problem increases while feeding, lying on the back, and crying. Generally symptoms start to be seen within the weeks after birth, and while there is clinical worsening around the fourth month, it is seen to spontaneously completely recover in the second year [ 7 , 8 ]. Diagnosis is based on the observation of supraglottic collapse in flexible laryngoscope examination [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…The physiopathology of laryngomalacia has not yet been fully clarified. Theories have been proposed related to neurological pathologies caused by submucosal nerve hypertrophy or changes in the sensorimotor integrative function [ 8 ]. Recent studies have shown that vitamin D may have a role in the etiology of laryngomalacia [ 2 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of vitamin D levels and biochemical markers in infants diagnosed with laryngomalacia

BİLAL,

ÇINAR,

İPEK

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim The pathology of laryngomalacia is still not clear. The aim of this study was to investigate the relationship between vitamin D levels and laryngomalacia, and to evaluate vitamin D levels according to the classification of laryngomalacia. Materials and methods This retrospective study was conducted in the Kahramanmara ş S ütçü İ mam University Medicine Faculty’s Otorhinolaryngology Clinic between June 2014 and January 2021. Laryngomalacia was classified. Laboratory tests for all patients included calcium (Ca), phosphorus (P), parathormone (PTH), blood urea nitrogen (BUN), creatinine (Cre), alanine transaminase (ALT), and 25-hydroxy vitamin D (25-OH-D). Results Evaluations were performed for 64 infants with laryngomalacia, including 41 male and 23 female infants with a mean age of 4.6 ± 3.0 months, and a control group of 64 healthy infants with a mean age of 4.5 ± 2.8 months. A statistically significant difference was determined between the laryngomalacia group and the control group with respect to 25-OH-D and PTH levels (p < 0.001). When data were examined according to laryngomalacia types, a statistically significant difference was determined between the groups for 25-OH-D, Ca, P, PTH, and ALT values. The 25-OH-D level was statistically significantly lower in the severe laryngomalacia group than in the mild and control groups (p < 0.001). A statistically significant difference was determined between the moderate and severe laryngomalacia groups and the control group regarding PTH levels (p < 0.001). Conclusion Vitamin D deficiency may have a role in the etiology of laryngomalacia, and this view is supported by the finding that there was a decrease in vitamin D levels associated with laryngomalacia classification. In addition, the reduction in PTH levels in infants with laryngomalacia may be explained by the change in Ca metabolism. It would be appropriate for further studies to investigate the response to vitamin D replacement therapy in patients with moderate and severe laryngomalacia.

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Congenital laryngomalacia: Is it an inflammatory disease? The role of vitamin D

Cited by 8 publications

References 29 publications

Laryngomalacia

Laryngomalacia

Evaluation of the pediatric airway: a review

Evaluation of vitamin D levels and biochemical markers in infants diagnosed with laryngomalacia

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