Division of Intensive Care and Pulmonology, University of Basel Children's Hospital UKBB, Basel, Switzerland.
Pediatr Pulmonol. 2018 Sep;53(9):1284-1287. doi: 10.1002/ppul.24117. Epub 2018 Jul 3.
Laryngeal clefts (LC) are uncommon but important causes of stridor in infants. Direct laryngoscopy is the recommended method for the detection of LC because LC may be missed by flexible endoscopy. As laryngomalacia by far outnumbers any other cause of stridor in this age group flexible bronchoscopy is usually the preferred method for the evaluation of significant infantile stridor. The aim is to illustrate how the application of CPAP assists the detection of LC during flexible endoscopy.
Continuous positive airway pressure (CPAP) is applied via endoscopy mask during flexible endoscopy, titrated to open the upper esophageal sphincter, and to spread the inter-arytenoid folds.
The application of CPAP of 10-15 cmH O resulted in visual unmasking of otherwise obscured LC in four young children assessed for congenital stridor.
CPAP helps visualize LC by flexible endoscopy obviating transition to direct laryngoscopy and manual exploration.
喉裂（LC）是婴儿喘鸣的罕见但重要原因。直接喉镜检查是检测 LC 的推荐方法，因为 LC 可能会被软式内镜遗漏。由于喉软化症远超过该年龄段任何其他喘鸣原因，因此对于严重婴儿喘鸣，通常首选柔性支气管镜检查。目的是说明在柔性内镜检查期间如何应用 CPAP 辅助检测 LC。
在柔性内镜检查期间，通过内镜面罩应用持续气道正压（CPAP），滴定至打开食管上括约肌，并展开杓状软骨间皱襞。
在评估先天性喘鸣的四名幼儿中，应用 10-15cmH₂O 的 CPAP 导致原本被遮挡的 LC 得到可视显露。
CPAP 通过柔性内镜检查有助于可视化 LC，避免了向直接喉镜检查和手动探查的过渡。
