van der Heijden Martijn, Dikkers Frederik G, Halmos Gyorgy B
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Pediatr Pulmonol. 2015 Dec;50(12):1368-73. doi: 10.1002/ppul.23186. Epub 2015 Mar 30.
Laryngomalacia is the most common cause of dyspnea and stridor in newborn infants. Laryngomalacia is a dynamic change of the upper airway based on abnormally pliable supraglottic structures, which causes upper airway obstruction. In the past, different classification systems have been introduced. Until now no classification system is widely accepted and applied. Our goal is to provide a simple and complete classification system based on systematic literature search and our experiences.
Retrospective cohort study with literature review.
All patients with laryngomalacia under the age of 5 at time of diagnosis were included. Photo and video documentation was used to confirm diagnosis and characteristics of dynamic airway change. Outcome was compared with available classification systems in literature.
Eighty-five patients were included. In contrast to other classification systems, only three typical different dynamic changes have been identified in our series. Two existing classification systems covered 100% of our findings, but there was an unnecessary overlap between different types in most of the systems. Based on our finding, we propose a new a classification system for laryngomalacia, which is purely based on dynamic airway changes.
The groningen laryngomalacia classification is a new, simplified classification system with three types, based on purely dynamic laryngeal changes, tested in a tertiary referral center: Type 1: inward collapse of arytenoids cartilages, Type 2: medial displacement of aryepiglottic folds, and Type 3: posterocaudal displacement of epiglottis against the posterior pharyngeal wall.
喉软化是新生儿呼吸急促和喘鸣的最常见原因。喉软化是基于声门上结构异常柔软的上呼吸道动态变化，可导致上呼吸道梗阻。过去已引入不同的分类系统。到目前为止，尚无分类系统被广泛接受和应用。我们的目标是基于系统的文献检索和我们的经验提供一个简单且完整的分类系统。
回顾性队列研究并进行文献综述。
纳入所有诊断时年龄小于5岁的喉软化患者。使用照片和视频记录来确诊并记录气道动态变化的特征。将结果与文献中现有的分类系统进行比较。
纳入了85例患者。与其他分类系统不同，在我们的系列研究中仅发现了三种典型的不同动态变化。两种现有的分类系统涵盖了我们所有的发现，但大多数系统中不同类型之间存在不必要的重叠。基于我们的发现，我们提出了一种新的喉软化分类系统，该系统完全基于气道动态变化。
格罗宁根喉软化分类是一种新的、简化的分类系统，有三种类型，完全基于喉部动态变化，已在三级转诊中心进行了测试：1型：杓状软骨向内塌陷；2型：杓会厌襞内侧移位；3型：会厌向后下移位贴于咽后壁。
