Department of Otolaryngology, Head and Neck Surgery, University of Iowa, Iowa City, IA, USA.
Department of Otolaryngology, Henry Ford Health System, Detroit, MI, USA.
Ann Otol Rhinol Laryngol. 2021 Mar;130(3):311-313. doi: 10.1177/0003489420948546. Epub 2020 Aug 8.
Multiple congenital abnormalities of the epiglottis have been reported and iatrogenic injuries to the larynx and subglottis are well known. We present a new pattern of defect not previously reported in the literature.
Epiglottic abnormalities at two institutions are reviewed. Cases of defects involving the lateral aspect of the epiglottis and aryepiglottic fold are identified. A literature review of known epiglottic defects is performed.
Two children possessing lateral notch injuries at the aryepiglottic attachment to the epiglottis are described. Both children have a history of multiple laryngeal instrumentation attempts and prolonged intubation. Both have swallowing difficulties and are gastrostomy dependent. Congenital epiglottic defects include aplasia and midline bifidity, however, no lateral congenital epiglottic defects have been reported.
Epiglottic defects, while rare, should be part of the differential for children with aspiration and feeding difficulties. A new pattern of defect is described and iatrogenic etiology proposed.
已有报道称会出现多种先天性会厌畸形,且喉和会厌下区的医源性损伤也广为人知。我们提出了一种以前文献中未曾报道过的新的缺损模式。
回顾了两个机构的会厌异常情况。确定了累及会厌外侧和杓会厌皱襞的缺损病例。对已知的会厌缺损进行文献复习。
描述了两个在会厌与杓会厌连接部存在侧向切迹损伤的儿童。这两个孩子都有多次尝试进行喉部仪器操作和长时间插管的病史。两者都有吞咽困难,需要胃造口术。先天性会厌缺损包括发育不全和中线二分性,但没有报告过侧向先天性会厌缺损。
会厌缺损虽然罕见,但对于有吸入和喂养困难的儿童,应作为鉴别诊断的一部分。本文描述了一种新的缺损模式,并提出了医源性病因。