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Endoscopic surgical management of inspiratory stridor in newborns and infants

Jeffrey Cheng1, Lee P Smith1

  • 1Division of Pediatric Otolaryngology, Cohen Children's Medical Center, New Hyde Park, NY; Department of Otolaryngology, Head and Neck Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY.

American Journal of Otolaryngology
|June 30, 2015
PubMed

Insights

Laryngomalacia is the most common cause of severe stridor in infants requiring surgery. Endoscopic surgery, like supraglottoplasty, effectively treats conditions such as laryngomalacia, vallecular cysts, and glottic webs.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Surgery
  • Neonatal Airway Management

Background:

  • Inspiratory stridor in infants can stem from various aerodigestive pathologies.
  • Differentiating laryngomalacia from other causes of stridor is crucial for appropriate management.
  • Endoscopic surgical interventions are increasingly utilized for infant airway conditions.

Purpose of the Study:

  • To compare the incidence of endoscopic surgical treatment for laryngomalacia versus other aerodigestive pathologies presenting with similar symptoms.
  • To evaluate the effectiveness and safety of endoscopic surgical management in infants with stridor.

Main Methods:

  • A consecutive case series design was employed.
  • Chart review of endoscopic surgical interventions in infants (≤12 months) with inspiratory stridor.
  • Exclusion criteria included syndromic conditions or prior intubation history.

Main Results:

  • 30 infants underwent endoscopic surgical intervention, with an average age of 2.7 months.
  • Laryngomalacia was the primary indication (70%), followed by vallecular cysts (23.3%) and anterior glottic webs (6.7%).
  • All patients experienced immediate resolution of stridor and feeding issues, with no need for revision surgery or altered nutrition.

Conclusions:

  • Laryngomalacia is the most frequent surgical indication for severe infant stridor.
  • Endoscopic surgery, particularly supraglottoplasty, demonstrated excellent outcomes for laryngomalacia.
  • Vallecular cysts represent a significant portion of surgically treated cases, highlighting the need to consider differential diagnoses for stridor.
Abstract

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