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Related Experiment Videos

Discoordinate pharyngolaryngomalacia

P Froehlich1, A B Seid, F Denoyelle

  • 1Département d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Hôpital E. Herriot, Lyon, France.

International Journal of Pediatric Otorhinolaryngology
|February 14, 1997
PubMed
Summary

Severe laryngomalacia can resist standard endoscopic treatments. A new condition, discoordinate pharyngolaryngomalacia (DPLM), requires additional interventions beyond supraglottoplasty for effective treatment.

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Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Surgical Innovation

Background:

  • Severe laryngomalacia often requires intervention.
  • Endoscopic supraglottoplasty is a common treatment for laryngomalacia.
  • Treatment failure in severe laryngomalacia is not well understood.

Purpose of the Study:

  • To describe cases of severe laryngomalacia unresponsive to endoscopic treatment.
  • To introduce and define discoordinate pharyngolaryngomalacia (DPLM).
  • To investigate reasons for treatment failure in severe laryngomalacia.

Main Methods:

  • Retrospective review of 82 children with severe laryngomalacia.
  • Definition and identification of discoordinate pharyngolaryngomalacia (DPLM).
  • Analysis of treatment outcomes for DPLM cases, including additional surgical interventions and non-invasive ventilation.

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Main Results:

  • 27 of 82 children (33%) had DPLM, characterized by complete supraglottic collapse without shortened aryepiglottic folds (AEFs) or redundant mucosa, plus pharyngomalacia.
  • Endoscopic treatment was insufficient in 16 DPLM patients.
  • 10 children required additional procedures (uvulopharyngopalatoplasty, choanal atresia repair, aortopexy); 13 needed tracheostomy, while 2 successfully used Bi-level positive airway pressure (BiPAP).

Conclusions:

  • Discoordinate pharyngolaryngomalacia (DPLM) represents a severe subtype of laryngomalacia.
  • Standard endoscopic supraglottoplasty may be inadequate for DPLM.
  • Further research is needed to define optimal treatment strategies for DPLM, potentially involving multi-level airway intervention.