Bhatta Subash, Gandhi Sachin, Ganesuni Dushyanth, Ghanpur Asheesh Dora
Department of Laryngology, Deenanath Mangeshkar Hospital and Research Centre, Erandwane, Pune, 411004 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2472-2476. doi: 10.1007/s12070-020-02212-1. Epub 2020 Oct 20.
Laryngomalacia is the most common cause of stridor. It is believed to be due to delayed development of the supraglottic structures. On the basis of presentation, it has been divided into 3 grades. Management is dependent upon the grades: Mild and moderate laryngomalacia are managed conservatively, while CO LASER supraglottoplasty is the surgical management of choice for severe disease. In this study we evaluated the outcomes of supraglottopasty in long term follow up. It was a retrospective study which included patients with severe laryngomalacia who have undergone supraglottoplasty for the dates from July 2013 to July 2018. Weight and height of the patients were taken during the follow up visit after one year and have been compared with that of the normal children of comparable age using the pediatrics growth charts. Follow up was done by telephonic conversation to evaluate the status of other symptoms associated with laryngomalacia. Total of 44 patients were included in the study, 47.7% and 52.3% females and males respectively. Weight for age, weight for height and height for age were normal in 80.9%, 80.9% and 76.1% of patients respectively after supraglottoplasty. Of the patients studied, stridor was resolved in 80.9%, early tiredness during play was resolved in 43.2%, swallowing was normal in 85.7% and there was no aspiration in 90.5%. It can be concluded that patients with severe laryngomalacia improved with respect to airway symptoms, as well as, weight and height on long term follow up after CO LASER supraglottoplasty. It is important to evaluate the general status of the patients as a whole to truly assess the success of the surgery in addition to the airway symptoms.
喉软化是喘鸣最常见的原因。据信这是由于声门上结构发育延迟所致。根据临床表现,它被分为3级。治疗方法取决于分级:轻度和中度喉软化采用保守治疗,而CO2激光声门上成形术是重度疾病的手术治疗选择。在本研究中,我们评估了声门上成形术的长期随访结果。这是一项回顾性研究,纳入了2013年7月至2018年7月期间接受声门上成形术的重度喉软化患者。在术后一年的随访中测量了患者的体重和身高,并使用儿科生长图表与年龄相仿的正常儿童进行了比较。通过电话交谈进行随访,以评估与喉软化相关的其他症状的状况。该研究共纳入44例患者,女性和男性分别占47.7%和52.3%。声门上成形术后,分别有80.9%、80.9%和76.1%的患者年龄别体重、身高别体重和年龄别身高正常。在研究的患者中,80.9%的喘鸣症状得到缓解,43.2%的玩耍时早期疲劳症状得到缓解,85.7%的吞咽功能正常,90.5%的患者无误吸。可以得出结论,重度喉软化患者在接受CO2激光声门上成形术后的长期随访中,气道症状以及体重和身高均有改善。除了气道症状外,评估患者的整体一般状况对于真正评估手术的成功与否很重要。