Di Dio D, Amrhein P, Koitschev A, Sittel C
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Standort Katharinenhospital, Klinikum Stuttgart, Stuttgart, Deutschland.
Abteilung pädiatrische HNO und Otologie, Standort Olgahospital, Klinikum Stuttgart, Stuttgart, Deutschland.
HNO. 2016 Dec;64(12):905-908. doi: 10.1007/s00106-016-0277-9.
Laryngomalacia is the most common cause of stridor in infants. The stridor is caused by an inward collapse of supraglottic structures during inspiration resulting in an inspiratory stridor. The exact etiology still remains unclear. The surgical procedure of choice for laryngomalacia is supraglottoplasty. From 2009 to 2016 a total of 71 children were treated by supraglottoplasty in the department for pediatric otorhinolaryngology of the Stuttgart Hospital. The indications for supraglottoplasty were laryngomalacia with severe inspiratory stridor, oxygen desaturation, suprasternal or chest retraction, feeding difficulties and/or failure to thrive. The overall success rate was 86 % but there was a clear difference between children with isolated laryngomalacia and the group with associated comorbidities. The success rate for patients with isolated laryngomalacia was 98 % and for patients with associated comorbidities 57 %. Supraglottoplasty is therefore an effective and safe treatment for symptomatic laryngomalacia and a reduction in the success rate showed a clear correlation with the presence of congenital comorbidities.
喉软化症是婴儿喘鸣最常见的原因。喘鸣是由于吸气时声门上结构向内塌陷导致吸气性喘鸣。确切病因仍不清楚。喉软化症的首选手术方法是声门上成形术。2009年至2016年,斯图加特医院儿科耳鼻喉科共有71名儿童接受了声门上成形术。声门上成形术的适应证为伴有严重吸气性喘鸣、氧饱和度下降、胸骨上或胸部凹陷、喂养困难和/或发育不良的喉软化症。总体成功率为86%,但单纯喉软化症患儿与合并其他疾病的患儿之间存在明显差异。单纯喉软化症患者的成功率为98%,合并其他疾病的患者为57%。因此,声门上成形术是治疗有症状喉软化症的一种有效且安全的方法,成功率的降低与先天性合并症的存在明显相关。