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Neurologic Evaluation in Children With Laryngeal Cleft
Ryan D Walker1, Alexandria L Irace1, Margaret A Kenna2
1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts.
JAMA Otolaryngology-- Head & Neck Surgery
|April 7, 2017
Summary
Neuromuscular dysfunction is common in patients with laryngeal cleft, impacting swallowing and increasing aspiration risk. Guidelines for neurologist referral and neuroimaging are needed for accurate diagnosis and management.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Neurology
- Diagnostic Imaging
Background:
- Laryngeal clefts can cause aspiration due to anatomical or neuromuscular issues.
- Current management lacks guidelines for neurological evaluation and imaging.
Purpose of the Study:
- To establish guidelines for neurological evaluation and neuroimaging in children with laryngeal cleft.
- To identify patients with laryngeal cleft who may have underlying neuromuscular dysfunction.
Main Methods:
- Retrospective review of 242 patients with laryngeal cleft.
- Analysis of neurological referral data, neuroimaging results, and swallow study outcomes.
Main Results:
- 35.5% of patients were referred to a neurologist, with 38.4% showing neuromuscular dysfunction.
- 64% of patients undergoing brain imaging had abnormal findings, including critical congenital malformations.
Conclusions:
- A significant portion of laryngeal cleft patients have coexistent neuromuscular dysfunction.
- Neurologist consultation and neuroimaging aid in diagnosis, prognosis, and identifying treatable malformations.
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