Laryngomalacia and swallowing function in children

Area of Science:

• Pediatric Otolaryngology
• Pediatric Gastroenterology
• Speech-Language Pathology

Background:

• Laryngomalacia is a common congenital condition affecting the larynx.
• Swallowing dysfunction (dysphagia) can be a significant complication in infants with laryngomalacia.
• The relationship between laryngomalacia severity, comorbidities, and dysphagia requires further investigation.

Purpose of the Study:

• To determine the prevalence of dysphagia in children with laryngomalacia.
• To assess if laryngomalacia severity impacts swallowing dysfunction.
• To examine if medical comorbidities increase dysphagia risk in laryngomalacia patients.

Main Methods:

• Retrospective cohort study of 324 children diagnosed with laryngomalacia.
• Swallowing function assessed via symptoms, clinical swallowing evaluations (CSE), modified barium swallow (MBS), and fiberoptic endoscopic evaluations of swallowing (FEES).
• Analysis of laryngomalacia severity, presence of comorbidities (GERD, Down syndrome, neurological impairment, congenital heart disease), and feeding difficulties.

Main Results:

• Dysphagia or feeding difficulties were present in 50.3% of patients; 9.6% experienced failure to thrive.
• 75.7% of patients showed at least one abnormal swallowing assessment, irrespective of subjective dysphagia symptoms.
• No significant link found between laryngomalacia severity and swallowing dysfunction, though severe cases were more prone to failure to thrive. GERD was more common in moderate/severe cases.

Conclusions:

• Swallowing dysfunction is highly prevalent in children with laryngomalacia, independent of disease severity or comorbidities.
• Abnormal swallowing studies are frequent, even in patients without overt dysphagia symptoms.
• Comprehensive dysphagia evaluation should be integral to the management of infants with laryngomalacia.