Pediatric Otolaryngology, Division of Pediatric Surgery, Department of Surgery, The Stollery Children's Hospital & University of Alberta Hospitals, Edmonton, Alberta, Canada.
Otolaryngol Head Neck Surg. 2011 Feb;144(2):268-73. doi: 10.1177/0194599810391600. Epub 2010 Dec 29.
To document the prevalence of secondary airway lesions (SALs) among children with laryngomalacia (LM).
A cross-sectional observational study.
Single practice in a tertiary care pediatric facility.
Patients diagnosed with LM were initially identified from a prospectively kept surgical database. Patients with cardiac/large-vessel malformations, prematurity, repeated or prolonged intubations, acute infections, or prior airway surgery were excluded. Only children who had a full examination of the airway were included. Other associated diagnoses along with demographics, surgical intervention, and type of LM were included.
Over an 8-year period, 1112 patients underwent laryngoscopy and bronchoscopy. A total of 108 consecutive cases were diagnosed with LM (78 primary diagnosis and 30 secondary diagnosis). After excluding 17 with disorders associated with large airway disease, 91 LM patients were included. The mean age was 553.23 days (ranging between 5 days and 15 years); 60 were boys and 31 were girls. The prevalence of SALs was 7.7% (95% confidence interval, 7.65-7.76; 7 children; 4 subglottic stenosis, 4 tracheomalacia, 1 bronchomalacia, and 1 choanal atresia). Fifty-nine patients underwent supraglottoplasties, while 1 patient had a tracheostomy.
After accounting for conditions known to be associated with large airway lesions, the prevalence of SALs associated with laryngomalacia was much less than previously reported. The authors hypothesize that the upper-end figures are a reflection of highly select cohorts and the inclusion of patients with other pathology known to be associated with subglottic stenosis, tracheomalacia, and bronchomalacia and low thresholds for diagnosing mild subglottic stenosis.
记录杓状软骨软化症（LM）患儿的继发气道病变（SALs）的发生率。
横断面观察性研究。
在一家三级保健儿科机构的单家诊所。
最初从一个前瞻性保存的手术数据库中确定诊断为 LM 的患者。排除存在心脏/大血管畸形、早产、反复或长时间插管、急性感染或先前有气道手术史的患者。仅纳入进行了气道全面检查的患者。还包括其他相关诊断以及人口统计学资料、手术干预和 LM 类型。
在 8 年期间，有 1112 例患者接受了喉镜和支气管镜检查。共有 108 例连续病例被诊断为 LM（78 例为原发性诊断，30 例为继发性诊断）。在排除 17 例与大气道疾病相关的疾病后，纳入 91 例 LM 患者。平均年龄为 553.23 天（范围为 5 天至 15 岁）；60 例为男孩，31 例为女孩。SALs 的发生率为 7.7%（95%置信区间，7.65-7.76；7 例；4 例声门下狭窄，4 例气管软化，1 例支气管软化，1 例后鼻孔闭锁）。59 例患者接受了杓状软骨成形术，1 例患者接受了气管造口术。
在考虑与大气道病变相关的已知疾病后，与 LM 相关的 SALs 的发生率远低于之前的报道。作者推测，之前的较高数据是高度选择的队列的反映，以及包括已知与声门下狭窄、气管软化和支气管软化相关的其他病理和对轻度声门下狭窄的诊断阈值较低的患者。
