Bent J P, Miller D A, Kim J W, Bauman N M, Wilson J S, Smith R J
Department of Otolaryngology-Head and Neck Surgery (Division of Pediatric Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, USA.
Ann Otol Rhinol Laryngol. 1996 Mar;105(3):169-75. doi: 10.1177/000348949610500301.
Laryngomalacia is a well-recognized cause of airway obstruction and inspiratory stridor in infants. As children grow and become more active, laryngomalacia may manifest in different, unexpected ways. Otherwise healthy athletes may generate enough inspiratory force to draw the aryepiglottic folds into the endolarynx, causing a subtotal glottic obstruction. This problem may be overlooked or attributed to asthma, lack of fitness, or functional abnormalities. The purpose of this report is to review the prevalence, diagnosis, and treatment of exercise-induced laryngomalacia (EIL) in children and young adults. To study the incidence and diagnosis of this disorder, we examined 10 healthy volunteers. Fiberoptic laryngoscopy was used to videotape each subject's larynx during active exercise on a stationary bicycle. All volunteers demonstrated altered laryngeal dynamics with exercise, and 1 of the 10 volunteers developed laryngomalacia. Anatomically, it appears that the aryepiglottic fold serves as the critical point of obstruction. When symptomatic, laryngomalacia may be treated with supraglottoplasty. We have had experience with 2 EIL patients in the last 12 months who have undergone carbon dioxide laser microlaryngoscopy. Both patients benefited significantly from surgery. We conclude that EIL is underdiagnosed but responds well to treatment.
喉软化症是婴儿气道阻塞和吸气性喘鸣的一个公认病因。随着儿童成长且活动增多，喉软化症可能会以不同的、意想不到的方式表现出来。原本健康的运动员可能会产生足够的吸气力量，将杓会厌襞吸入喉内，导致声门部分阻塞。这个问题可能会被忽视，或归因于哮喘、身体不适或功能异常。本报告的目的是回顾儿童和青年运动诱发喉软化症（EIL）的患病率、诊断和治疗。为研究这种疾病的发病率和诊断，我们检查了10名健康志愿者。在固定自行车上进行有氧运动时，使用纤维喉镜对每个受试者的喉部进行录像。所有志愿者在运动时均表现出喉部动力学改变，10名志愿者中有1名患喉软化症。从解剖学上看，杓会厌襞似乎是阻塞的关键点。有症状时，喉软化症可用声门上成形术治疗。在过去12个月里，我们有2例EIL患者接受了二氧化碳激光显微喉镜检查。两名患者均从手术中显著获益。我们得出结论：EIL诊断不足，但对治疗反应良好。
