Petersson Rajanya S, Wetjen Nicholas M, Thompson Dana M
Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55905, USA.
Ann Otol Rhinol Laryngol. 2011 Feb;120(2):99-103. doi: 10.1177/000348941112000205.
Two infants presented with intermittent stridor and evidence of laryngomalacia on flexible laryngoscopy. The first was a 10-month-old girl who had undergone 3 supraglottoplasty surgeries at an outside institution, without long-term resolution of symptoms. She was found during our evaluation to have a Chiari malformation. Laryngomalacia symptoms resolved after suboccipital decompression and C1 laminectomy, and the patient remained symptom-free at 6-month follow-up. The second infant was a 24-day-old boy with velocardiofacial syndrome who was found to have posterior cervicomedullary junction compression at the level of C1. He underwent C1 laminectomy for decompression of the brain stem, which resulted in immediate resolution of symptoms, and he remained symptom-free at 12-month follow-up. Neurologic abnormalities have been reported in up to 50% of infants with laryngomalacia. As such, brain stem dysfunction should be considered among the causes of laryngomalacia during evaluation, especially in patients with failure of supraglottoplasty. Both of these infants had resolution of symptoms after their neurosurgical procedures.
两名婴儿出现间歇性喘鸣，经软性喉镜检查有喉软化症迹象。第一名是一名10个月大的女孩，曾在外部机构接受过3次声门上成形术，但症状未得到长期缓解。在我们的评估中发现她患有Chiari畸形。枕下减压和C1椎板切除术后，喉软化症症状得到缓解，患者在6个月的随访中无症状。第二名婴儿是一名24天大的患有腭心面综合征的男孩，在C1水平发现有颈髓后联合受压。他接受了C1椎板切除术以减压脑干，症状立即得到缓解，在12个月的随访中他一直无症状。据报道，高达50%的喉软化症婴儿存在神经学异常。因此，在评估喉软化症病因时应考虑脑干功能障碍，尤其是在声门上成形术失败的患者中。这两名婴儿在神经外科手术后症状均得到缓解。
