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[Laryngeal anomalies in newborn infants. Apropos of 687 cases]
Insights
Congenital laryngeal anomalies are a common cause of breathing difficulties in infants. This study reviews 687 cases, detailing various anomalies and their treatments.
Area of Science:
- Pediatric Otolaryngology
- Neonatal Respiratory Medicine
- Congenital Disorders
Context:
- Congenital laryngeal anomalies present significant diagnostic and emergency treatment challenges in neonates and infants.
- Clinical signs range from stridor and dyspnea to apnea, cyanosis, bradycardia, and cardiac arrest.
- A retrospective analysis of 687 infant case reports from 1974-1983 was performed.
Purpose:
- To review and categorize congenital laryngeal anomalies in infants.
- To analyze the incidence and clinical presentation of various laryngeal lesions.
- To discuss diagnostic findings and therapeutic approaches for each anomaly.
Summary:
- Laryngomalacia (50%) was the most frequent anomaly, with 15% severe cases.
- Laryngeal palsy occurred in 23% of cases (bilateral/unilateral).
- Other anomalies included stenosis (11%), subglottic hematoma, cysts, diastema, and bifid epiglottis.
Impact:
- Provides a comprehensive overview of congenital laryngeal anomalies in a large infant cohort.
- Highlights the spectrum of clinical presentations and the relative frequencies of different lesions.
- Informs diagnostic and emergency treatment strategies for neonates and infants with airway obstruction.
Abstract:
Congenital laryngeal anomalies are a frequent cause of obstructive dyspnea in neonates and young infants, and raise diagnostic and emergency treatment problems. Clinical symptomatology includes stridor of variable severity, obstructive dyspnea and deglutition disorders, but a less typical picture may be seen of apnea, cyanotic episodes, bradycardia and even cardiac arrests. A retrospective study of 687 case-reports of infants treated between 1974 and 1983 was conducted. Lesions included essential congenital laryngeal stridor (laryngomalacia) in 378 cases (50%), of which 15% were severe with respiratory distress and/or deglutition disorders; laryngeal palsy in 161 cases (23%), bilateral in 56 and unilateral in 105 cases; laryngeal incoordination in 23 cases; laryngeal stenosis: 79 cases (11%) including 58 subglottic and 18 dysphragmatic stenoses and 3 atresias; subglottic hematoma: 49 cases; ary-epiglottic or glosso-epiglottic cyst: 15 cases; laryngeal diastema: 11 cases; and bifid epiglottis: 1 case. Clinical, radiologic and endoscopic findings, and the principal therapies used, are discussed for each anomaly.