Division of Otolaryngology–Head and Neck Surgery, Pennsylvania State College of Medicine, Hershey, USA.
Am J Otolaryngol. 2012 Jul-Aug;33(4):437-40. doi: 10.1016/j.amjoto.2011.10.021. Epub 2011 Dec 16.
The aim of this study was to describe and compare the airway findings in term and preterm infants with laryngomalacia.
A retrospective review of 130 patients diagnosed as having laryngomalacia at a tertiary referral center between July 2004 and August 2009 was conducted. Medical records were reviewed for demographic data, supraglottic and glottic airway findings, concomitant airway lesions, and the need for intervention.
The mean gestational age and age at diagnosis was 36 and 15 weeks, respectively. Combined posterior and anterior supraglottic collapse was the most common finding (31%). Posterior collapse alone occurred in 25%, anterior collapse in 14%, and lateral collapse in 10%. Twelve percent of patients had all 3 sites of collapse. Forty-one percent of patients had a secondary airway lesion, with tracheomalacia being the most common. Preterm infants had significantly higher rates of reflux and more sites of collapse than did term infants (P < .0001). Eight patients required an intervention for their symptoms.
Children with laryngomalacia tend to have more than 1 area of supraglottic collapse, and more than one third have a secondary lesion. All patients who required an intervention had more than 1 area of collapse, and 63% of these patients had a secondary airway lesion. Our high incidence of secondary lesions is similar to recent reports.
本研究旨在描述并比较先天性喉软骨软化症足月和早产儿的气道表现。
回顾性分析 2004 年 7 月至 2009 年 8 月在一家三级转诊中心诊断为先天性喉软骨软化症的 130 例患者的资料。分析内容包括人口统计学数据、会厌和声门以上气道的发现、并存的气道病变以及干预的需求。
患者的平均胎龄和诊断时的年龄分别为 36 周和 15 周。最常见的表现是会厌前后联合塌陷（31%），单纯会厌后塌陷占 25%，单纯会厌前塌陷占 14%，单纯会厌侧塌陷占 10%。12%的患者存在 3 个部位的塌陷。41%的患者存在继发气道病变，以气管软化症最为常见。与足月儿相比，早产儿的胃食管反流发生率更高，且塌陷部位更多（P<0.0001）。8 例患者因症状而行干预治疗。
先天性喉软骨软化症患儿多存在 1 个以上的会厌以上气道塌陷部位，超过三分之一的患儿存在继发病变。所有需要干预治疗的患者均存在 1 个以上的塌陷部位，其中 63%的患者存在继发气道病变。我们继发气道病变的发生率较高，与近期的报道相似。
