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Published on: July 14, 2023
Neonatal Lateral Epiglottic Defects
Joseph D Peterson1, Vinay Goyal2, Michael D Puricelli1
1Department of Otolaryngology, Head and Neck Surgery, University of Iowa, Iowa City, IA, USA.
Insights
A novel lateral epiglottic defect, potentially caused by medical procedures, is described in two children with feeding difficulties. This finding expands the understanding of epiglottic abnormalities in pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Congenital Abnormalities
- Iatrogenic Injury
Background:
- Congenital epiglottic abnormalities are rare but documented.
- Iatrogenic injuries to the larynx and subglottis are recognized complications.
Observation:
- Two pediatric cases presented with lateral notch defects at the aryepiglottic attachment to the epiglottis.
- Both patients had a history of multiple laryngeal instrumentation and prolonged intubation.
- These defects were associated with significant swallowing difficulties, necessitating gastrostomy dependence.
Findings:
- A previously unreported pattern of lateral congenital epiglottic defect was identified.
- Existing literature details congenital epiglottic defects like aplasia and midline bifidity, but not lateral defects.
- The observed lateral defects are proposed to be iatrogenic in etiology.
Implications:
- Lateral epiglottic defects should be considered in the differential diagnosis for pediatric patients experiencing aspiration and feeding difficulties.
- This study highlights a potential iatrogenic cause for specific epiglottic malformations.
- Further research is warranted to fully understand the incidence and management of these rare defects.
Introduction:
Multiple congenital abnormalities of the epiglottis have been reported and iatrogenic injuries to the larynx and subglottis are well known. We present a new pattern of defect not previously reported in the literature.
Methods:
Epiglottic abnormalities at two institutions are reviewed. Cases of defects involving the lateral aspect of the epiglottis and aryepiglottic fold are identified. A literature review of known epiglottic defects is performed.
Results:
Two children possessing lateral notch injuries at the aryepiglottic attachment to the epiglottis are described. Both children have a history of multiple laryngeal instrumentation attempts and prolonged intubation. Both have swallowing difficulties and are gastrostomy dependent. Congenital epiglottic defects include aplasia and midline bifidity, however, no lateral congenital epiglottic defects have been reported.
Conclusion:
Epiglottic defects, while rare, should be part of the differential for children with aspiration and feeding difficulties. A new pattern of defect is described and iatrogenic etiology proposed.
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