Laryngomalacia surgery: a series from a tertiary pediatric hospital

Netto, José Faibes Lubianca; Drummond, Renata Loss; Oppermann, Luciana Pimentel; Hermes, Fernando; Krumenauer, Rita Carolina Pozzer

doi:10.5935/1808-8694.20120041

Cited by 13 publications

(17 citation statements)

References 32 publications

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“…Forty-four studies were excluded for the following reasons: the number of patients undergoing polysomnography pre-and postsupraglottoplasty was not provided 43 ; no quantitative data for polysomnograms was provided 12,18,21,22,[24][25][26]28,29,[32][33][34][35][36][37][38][39]41,42,[44][45][46]49,51,53,54,56,58,61,64,66 ; only adults were included 19 ; procedure(s) were performed in addition to the supraglottoplasty with no stratification of data for those who underwent isolated supraglottplasty 27,50,63 ; only preoperative data was available 55 ; some children were sedated with choral hydrate 47 ; the postoperative data was only available for a fraction of patients 30 ; portable pulse-oximetry was used instead of formal polysomnography 31 ; or they were review articles. 40,52,62 Overall, there were a total of 138 patients (ages 1 month-12.6 years) with quantitative polysomnographic data who underwent isolated supraglottoplasty.…”

Section: Resultsmentioning

confidence: 99%

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

et al. 2015

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Objectives/Hypothesis: To determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve following isolated supraglottoplasty for laryngomalacia with obstructive sleep apnea (OSA) in children.Study Design: Systematic review and meta-analysis. Methods: Nine databases, including PubMed/MEDLINE, were searched through September 30, 2015.Results: A total of 517 studies were screened; 57 were reviewed; and 13 met criteria. One hundred thirty-eight patients were included (age range: 1 month-12.6 years). Sixty-four patients had sleep exclusive laryngomalacia, and in these patients: 1) AHI decreased from a mean (M) 6 standard deviation (SD) of 14.0 6 16.5 (95% confidence interval [CI] 10.0, 18.0) to 3.3 6 4.0 (95% CI 2.4, 4.4) events/hour (relative reduction: 76.4% [95% CI 53.6, 106.4]); 2) LSAT improved from a M 6 SD of 84.8 6 8.4% (95% CI 82.8, 86.8) to 87.6 6 4.4% (95% CI 86.6, 88.8); 3) standardized mean differences (SMD) demonstrated a small effect for LSAT and a large effect for AHI; and 4) cure (AHI < 1 event/hour) was 10.5% (19 patients with individual data). Seventy-four patients had congenital laryngomalacia, and in these patients: 1) AHI decreased from a M 6 SD of 20.4 6 23.9 (95% CI 12.8, 28.0) to 4.0 6 4.5 (95% CI 2.6, 5.4) events/hour (relative reduction: 80.4% [95% CI 46.6, 107.4]); 2) LSAT improved from a M 6 SD of 74.5 6 11.9% (95% CI 70.9, 78.1) to 88.4 6 6.6% (95% CI 86.4, 90.4); 3) SMD demonstrated a large effect for both AHI and LSAT; and 4) cure was 26.5% (38 patients with individual data).Conclusion: Supraglottoplasty has improved AHI and LSAT in children with OSA and either sleep exclusive laryngomalacia or congenital laryngomalacia; however, the majority of them are not cured.

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Section: Resultsmentioning

confidence: 99%

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

et al. 2015

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“…Laringomalasia (LM) merupakan keadaan yang menggambarkan kolapsnya struktur supraglotis laring selama inspirasi sehingga mengakibatkan menyempitnya aliran udara selama inspirasi. [1][2][3][4] Sekitar 60-75 % kasus stridor kongenital disebabkan oleh LM. 2,3 Istilah laringomalasia pertama kali diperkenalkan oleh Jackson dan Jackson pada tahun 1942 untuk menggambarkan stridor inspirasi kongentital akibat kolapsnya struktur laring saat inspirasi dimana kejadian ini tidak ditemukan pada stridor inspirasi kongenital lainnya.…”

Section: Pendahuluanunclassified

“…[1][2][3][4] Sekitar 60-75 % kasus stridor kongenital disebabkan oleh LM. 2,3 Istilah laringomalasia pertama kali diperkenalkan oleh Jackson dan Jackson pada tahun 1942 untuk menggambarkan stridor inspirasi kongentital akibat kolapsnya struktur laring saat inspirasi dimana kejadian ini tidak ditemukan pada stridor inspirasi kongenital lainnya. 5,6 Angka kejadian LM di dunia belum diketahui secara pasti, namun lebih banyak ditemukan pada anak laki-laki sebanyak 58-76% kasus, dan tidak terdapat predileksi terhadap ras tertentu.…”

Section: Pendahuluanunclassified

“…5,6 Angka kejadian LM di dunia belum diketahui secara pasti, namun lebih banyak ditemukan pada anak laki-laki sebanyak 58-76% kasus, dan tidak terdapat predileksi terhadap ras tertentu. 2 Menurut data rekam medis RS Hasan Sadikin Bandung mulai Januari 2012 sampai Maret 2015 terdapat 84 kasus LM (55 kasus laki-laki dan 29 perempuan). 7 Laringomalasia mempunyai karakteristik stridor yang timbul dalam dua minggu pertama kehidupan sampai beberapa bulan kehidupan bayi.…”

Section: Pendahuluanunclassified

“…Pemilihan jenis operasi berdasarkan tipe LM berupa supraglotoplasti dengan melakukan eksisi mukosa aritenoid redundant pada tipe I, insisi lipatan ariepiglotis yang memendek pada tipe II dan epiglotoplasti pada LM tipe III (gambar 6). 5,6,18 (1).Pemisahan lipatan ariepiglotis unilateral, (2).Pemisahan lipatan ariepiglotis bilateral, (3).Pemisahan lipatan ariepiglotis bilateral dengan pengangkatan jaringan aritenoid redundant unilateral dan (4). Pemisahan komplit bilateral (gambar 7).…”

Section: Pembedahanunclassified

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Diagnosis dan Penatalaksanaan Laringomalasia

Elfianto

Novialdi

2018

JKA

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AbstrakLatar belakang: Laringomalasia (LM) merupakan penyebab tersering stridor inspirasi kongenital pada bayi. Sekitar 80% kasus merupakan derajat ringan dan sedang yang dapat membaik serta resolusi sampai usia 2 tahun sedangkan 20% merupakan derajat berat yang membutuhkan tindakan pembedahan Tujuan: Mengetahui dan memahami etiologi, diagnosis dan penatalaksanaan laringomalasia. Tinjauan Pustaka: Diagnosis laringomalasia dapat ditegakkan dari anamnesis, pemeriksaan fisik serta pemeriksaan penunjang laringoskopi serat optic fleksibel. Etiologi pasti laringomalasia belum diketahui, namun terdapat 3 teori yang diduga berperan yaitu imaturitas kartilago, imaturitas neuromuskular dan abnormalitas anatomi. Terdapat hubungan antara laringomalasia dengan laryngopharyngeal reflux (LPR). Penatalaksanaan konservatif dilakukan pada LM derajat ringan dan sedang sedangkan tindakan pembedahan dilakukan pada derajat berat, laringomalasia dengan komorbid dan laringomalasia yang gagal terapi konservatif. Kesimpulan: Laringomalasia merupakan kolapsnya struktur supraglotis ketika inspirasi yang mengakibatkan adanya stridor inspirasi. Laringomalasia derajat berat dapat mengancam nyawa. Sebagian besar kasus akan resolusi sendiri, namun sekitar 20% memerlukan tindakan pembedahan. Supraglottoplasti merupakan tindakan pembedahan pilihan untuk kasus laringomalasia Kata kunci: Laringomalasia, stridor inspirasi, laringoskopi serat optik fleksibel, supraglottoplasti AbstractBackground : Laryngomalacia (LM) is the most common cause of inspiration stridor in infant. About 80% cases are mild and moderate that can improvement and resolution by 2 years of age, and aboout 20% cases is severe that need surgical intervention. Objective : Knowing and understanding etiology, diagnosis and management of laryngomalacia. Literature review :. Diagnosis of laryngomalacia is obtained from the history, phisical examination and supporting examination such as flexible fibreoptic laryngoscopy (FFL) . The etiology was unknown, but there are some theory that can explain cause of laryngomalacia such as cartilage immaturity, neuromuscular immaturity, an anatomic abnormality. There is corelation between laryngomalacia and laryngopharingeal reflux disease (LPR). Conservative treatment choosing for mild and moderate laryngomalacia and surgical intervention perform for severe laryngomalacia, laryngomalacia with comorbid disease and laryngomalacia which failed with conservative treatment. Conclusion : Laryngomalacia is a condition of supraglottic structure collaps into the airway during inspiratory phase that produce inspiration stridor and can make life threatening. Most of the cases are self limiting resolution, only about 20% need surgical intervention. Supraglottoplasty is the choice surgical procedure for laryngomalacia.

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Evaluation and Management of the Pediatric Airway

Truong¹,

Messner²

2015

Cummings Pediatric Otolaryngology

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Laryngomalacia surgery: a series from a tertiary pediatric hospital

Cited by 13 publications

References 32 publications

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

Supraglottoplasty for laryngomalacia with obstructive sleep apnea: A systematic review and meta‐analysis

Diagnosis dan Penatalaksanaan Laringomalasia

Evaluation and Management of the Pediatric Airway

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