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Pesquisa : C05.182.310 [Categoria DeCS]
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[PMID]:29443747
[Au] Autor:Pu S; Xu H; Li X
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
[Ti] Título:Supraglottoplasty in neonates and infants: A radiofrequency ablation approach.
[So] Source:Medicine (Baltimore);97(7):e9850, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Supraglottoplasty is the mainstay of surgical treatment for laryngomalacia. A novel supraglottoplasty surgical technique is needed to achieve better efficacy. The purpose of this study was to introduce modified microscopic radiofrequency ablation supraglottoplasty (MMRAS) for the treatment of congenital laryngomalacia and to evaluate the outcome and effectiveness of this novel approach. METHODS: Seventeen children with severe laryngomalacia who underwent MMRAS were studied retrospectively. Supraglottoplasty of type III laryngomalacia was different from classical method. All the patients were kept intubated for 5 days after surgery to achieve a better epiglottal position and to avoid reconglutination of aryepiglottic folds. The patients' demographic information, symptoms, comorbidities, type of laryngomalacia, synchronous airway lesions and final outcomes were examined. RESULTS: The median age at the time of surgery was 3.36 months (3 months 10 days). Operative indications included feeding difficulties, noisy breathing or respiratory distress (or both), and sleep-related symptoms. The MMRAS success rate was 82.4%. Most patients were extubated successfully on postoperative day 5. The major postoperative complication was pulmonary infection which occurred in 3 cases (17.6%) and required anti-infective therapy. No perioperative deaths and no long-term complications occurred. Failures were observed in 3 (17.6%) of 17 cases, 2 patients presented with a neurological disease and required tracheostomy, 1 patient relapsed because of postoperative adhesions and later underwent revision supraglottoplasty. CONCLUSIONS: From these results, we conclude that MMRAS is an effective and safe treatment for symptomatic laryngomalacia and has the potential to provide better breathing, feeding, and sleeping outcomes in children with severe laryngomalacia. Postoperative intubation for 5 days may result in better therapeutic outcomes. Multicenter cooperative studies of comparison between MMRAS and conventional approaches would lend further evidence-based support for this surgical method.
[Mh] Termos MeSH primário: Ablação por Cateter/métodos
Epiglote/cirurgia
Laringomalácia/cirurgia
Microcirurgia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009850


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[PMID]:29287857
[Au] Autor:Ching HH; Spinner AG; Reeve NH; O-Lee TJ
[Ad] Endereço:Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las Vegas School of Medicine, 1701 W. Charleston Blvd., Suite #490, Las Vegas, NV 89102, USA. Electronic address: harry.ching@unlv.edu.
[Ti] Título:A novel technique for unilateral supraglottoplasty.
[So] Source:Int J Pediatr Otorhinolaryngol;104:150-154, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Traditional supraglottoplasty for pediatric laryngomalacia is most commonly conducted with either CO2 laser or cold steel instruments. While the procedure enjoys high success rates, serious complications such as excessive bleeding, supraglottic stenosis and aspiration can occur. Unilateral coblation supraglottoplasty may reduce this risk, but data on respiratory and swallowing outcomes are lacking. This study reports our experiences with unilateral coblation supraglottoplasty. METHODS: Pediatric patients with severe congenital laryngomalacia who underwent unilateral supraglottoplasty at a single institution from 2013 to 2016 were retrospectively reviewed. Bipolar radiofrequency ablation (Coblation) was utilized with partial arytenoidectomy, aryepiglottoplasty, and advancement of mucosal flaps. Outcome measures included apnea-hypopnea index (AHI), weight-by-age percentile, and decannulation rate. RESULTS: Twelve patients were included with an average age of 13.1 months (range 2-28 months). In patients without tracheostomy, 88% had complete resolution of respiratory symptoms, while the remainder had significant improvement. In patients without gastrostomy tubes, there was an average increase in weight-age percentile of 6.1, 7.8, and 15.3 points at 1, 3, and 6 months postoperatively, respectively. Three patients had complete polysomnography data with a mean preoperative AHI of 19.3 and postoperative AHI of 4.0. Three of four patients with tracheostomy have been decannulated at a mean follow-up of 1.5 years. There were no early or late postoperative complications and no revision supraglottoplasty. CONCLUSION: Unilateral supraglottoplasty with bipolar radiofrequency ablation can improve respiratory symptoms and decrease OSA severity in severe congenital laryngomalacia. This technique is safe and can lead to substantial improvement in AHI in patients with OSA.
[Mh] Termos MeSH primário: Ablação por Cateter/métodos
Laringomalácia/cirurgia
Laringoplastia/métodos
[Mh] Termos MeSH secundário: Ablação por Cateter/efeitos adversos
Pré-Escolar
Feminino
Seres Humanos
Lactente
Laringomalácia/congênito
Laringoplastia/efeitos adversos
Masculino
Complicações Pós-Operatórias/cirurgia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:29224749
[Au] Autor:Sedaghat S; Fredes F; Tapia M
[Ad] Endereço:Otolaryngologist at University of Concepcion and Hospital Guillermo Grant Benavente, Concepcion, Chile. Electronic address: sahbasedaghat@gmail.com.
[Ti] Título:Supraglottoplasty for laryngomalacia: The experience from Concepcion, Chile.
[So] Source:Int J Pediatr Otorhinolaryngol;103:113-116, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To review the clinical manifestations and outcomes of supraglottoplasty in patients with moderate to severe laryngomalacia at Guillermo Grant Benavente Hospital between January 2015 and January 2017. METHODS: Retrospective study of patients with laryngomalacia who underwent CO2 laser supraglottoplasty at a tertiary referral center. A review of medical records of these patients was performed. Epidemiological data along with symptoms, comorbidities, morphological type of laryngomalacia, synchronous airway lesions, surgery outcomes and satisfaction of parents after the procedure were recorded. Surgical success was defined as the resolution of the criteria of severity of laryngomalacia. RESULTS: Twenty-four patients were operated, 1 was excluded due to prior tracheostomy. Twenty-three patients were included, the median age at the time of surgery was 5.5 months. All the patients had stridor, 87% presented feeding difficulties, 34.8 % had cyanosis and 21.7% had failure to thrive. Six cases had congenital anomalies and four cases had nongenetic comorbidities. Fifteen patients (65.2%) had synchronous airway lesions. 17.4% had type I laryngomalacia and 82.6% were type 2. The postoperative average hospital stay was 1.3 days. The average follow-up was 14 months and no complications were reported. The overall success rate of surgery was 95%. CONCLUSIONS: Patients with laryngomalacia and any symptom of severity should undergo a full airway evaluation, to rule out synchronous airway lesions, and supraglottoplasty if needed, as it has been shown to be a safe and effective technique for the management of these patients.
[Mh] Termos MeSH primário: Laringomalácia/cirurgia
Lasers de Gás/uso terapêutico
Procedimentos Cirúrgicos Reconstrutivos/métodos
Supraglotite/cirurgia
[Mh] Termos MeSH secundário: Pré-Escolar
Chile
Feminino
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:28688573
[Au] Autor:Cooper T; Harris B; Mourad A; Garros D; El-Hakim H
[Ad] Endereço:Division of Otolaryngology-Head and Neck Surgery, Canada.
[Ti] Título:Comparison between selective and routine intensive care unit admission post-supraglottoplasty.
[So] Source:Int J Pediatr Otorhinolaryngol;99:90-94, 2017 Aug.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare major post-operative respiratory complications, post-operative disposition and duration of hospital admission before and after adopting a selective intensive care unit (ICU) admission care plan following supraglottoplasty (SGP). METHODS: Retrospective case series set in a tertiary pediatric referral center. Eligible patients undergoing SGP between October 2003 and July 2015 were identified through a prospectively kept surgical database. Historical cohorts with routine admission to ICU and selective admission to ICU were identified based on a shift in surgeon practice. The cohorts were compared with respect to demographics, presenting features, endoscopic findings, baseline sleep and swallowing study results, major respiratory complications (including repeat or unplanned ICU admission or intubation) and length of post-operative hospital admission. RESULTS: 141 eligible patients were identified with 35 children in the routine ICU admission cohort and 106 in the selective ICU admission cohort. There were no significant differences between cohorts regarding major respiratory complications with only one patient in the selective ICU admission cohort requiring an unplanned admission to ICU (P = 1.00, Fisher's exact test). This gives a number needed to harm of 78 step-down unit admissions for 1 unplanned ICU admission. The rate of ICU admission was reduced from 71% to 26% with adoption of a selective ICU admission care plan (p < 0.01, χ ). Mean duration of post-operative hospitalization was reduced from 5.1 ± 3.5 days to 1.9 ± 2.3 days (P < 0.01, Student's t-test). CONCLUSIONS: Selective post-operative ICU admission following SGP significantly reduces ICU utilization and may reduce length of hospital stay without compromising safety and care. This has significant cost benefit implications.
[Mh] Termos MeSH primário: Glote/cirurgia
Unidades de Terapia Intensiva/estatística & dados numéricos
Laringomalácia/cirurgia
Admissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Análise Custo-Benefício
Bases de Dados Factuais
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Lactente
Tempo de Internação/estatística & dados numéricos
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE


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[PMID]:28511742
[Au] Autor:Chan S; Siou G; Welch A; Powell S
[Ad] Endereço:Department of Otolaryngology Head and Neck Surgery,Freeman Hospital,Newcastle upon Tyne,UK.
[Ti] Título:Predictors for routine admission to paediatric intensive care for post-supraglottoplasty laryngomalacia patients.
[So] Source:J Laryngol Otol;131(7):640-644, 2017 Jul.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Supraglottoplasty for the treatment of laryngomalacia has little current evidence regarding post-operative care. Our study aimed to: (1) retrospectively assess what proportion of patients required paediatric intensive care unit level of care; (2) identify pre-operative predictive factors common to these cases; and (3) report patient outcomes at six weeks' follow up. METHODS: A 10-year retrospective case series analysis was conducted of all patients diagnosed with laryngomalacia and subsequently treated with supraglottoplasty. Paediatric intensive care unit level of care was defined as the need for intubation or tracheostomy, positive pressure ventilation, multiple doses of nebulised adrenaline, and oxygen dependency beyond 12 hours. RESULTS: Forty-two patients (19 males, 23 females) were identified; 28.5 per cent of cases met our criteria for paediatric intensive care unit level of care. A low pre-operative oxygen saturation was the only significant risk factor that predicted a future need for paediatric intensive care unit level of care (p = 0.0008). CONCLUSION: This is the first study published in the UK to suggest the importance of pre-operative oxygen saturation as a predictor of a future need for paediatric intensive care unit level of care.
[Mh] Termos MeSH primário: Técnicas de Apoio para a Decisão
Glote/cirurgia
Unidades de Terapia Intensiva Pediátrica
Laringomalácia/terapia
Admissão do Paciente
Cuidados Pós-Operatórios/métodos
[Mh] Termos MeSH secundário: Administração por Inalação
Pré-Escolar
Epinefrina/administração & dosagem
Feminino
Seres Humanos
Lactente
Recém-Nascido
Intubação Intratraqueal
Laringomalácia/diagnóstico
Masculino
Oxigênio/sangue
Respiração com Pressão Positiva
Estudos Retrospectivos
Fatores de Risco
Traqueostomia
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
S88TT14065 (Oxygen); YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117001074


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[PMID]:28224634
[Au] Autor:Luebke K; Samuels TL; Chelius TH; Sulman CG; McCormick ME; Kerschner JE; Johnston N; Chun RH
[Ad] Endereço:Department of Otolaryngology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, U.S.A.
[Ti] Título:Pepsin as a biomarker for laryngopharyngeal reflux in children with laryngomalacia.
[So] Source:Laryngoscope;127(10):2413-2417, 2017 Oct.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES/HYPOTHESIS: Laryngomalacia is a common cause of newborn stridor. Laryngopharyngeal reflux (LPR) has been associated with laryngomalacia. Although pepsin, a component of LPR, has been associated with inflammatory diseases of the aerodigestive tract, its presence in the airways of laryngomalacia patients is unknown. STUDY DESIGN: Prospective case-control study comparing patients under age 3 years with laryngomalacia to children without laryngomalacia. METHODS: Children less than 3 years old undergoing supraglottoplasty for laryngomalacia or surgery unrelated to the airway, without a history of laryngomalacia, reflux, or respiratory disease, were offered enrollment. Supraglottic lavage samples (3 mL) were obtained from all subjects. Two-millimeter arytenoid biopsies were collected from laryngomalacia patients. Pepsin Western blot and enzyme-linked immunosorbent assay were performed. RESULTS: Ten laryngomalacia and five control subjects were enrolled. Pepsin was detected in lavages of laryngomalacia patients (8/10) but absent in controls (0/5; P = .007). Pepsin was observed more frequently in lavages (8/10) than biopsies (4/10; P = .046) of laryngomalacia subjects. Higher median pepsin concentration was observed in laryngomalacia than control lavages (P = .025). CONCLUSIONS: Pepsin in supraglottic specimens demonstrated an association with laryngomalacia, supporting a role for refluxed pepsin in laryngomalacia. These data corroborate previous work implicating pepsin in inflammatory diseases of the upper airways. Further studies are warranted to investigate the contribution of pepsin to the pathophysiology of laryngomalacia. LEVEL OF EVIDENCE: 3b. Laryngoscope, 127:2413-2417, 2017.
[Mh] Termos MeSH primário: Mucosa Laríngea/metabolismo
Laringomalácia/complicações
Refluxo Laringofaríngeo/metabolismo
Pepsina A/metabolismo
[Mh] Termos MeSH secundário: Biomarcadores/metabolismo
Biópsia
Western Blotting
Estudos de Casos e Controles
Eletroforese em Gel de Poliacrilamida
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Lactente
Laringomalácia/diagnóstico
Laringomalácia/metabolismo
Refluxo Laringofaríngeo/diagnóstico
Refluxo Laringofaríngeo/etiologia
Masculino
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); EC 3.4.23.1 (Pepsin A)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26537


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[PMID]:28109487
[Au] Autor:Weinstein JE; Lawlor CM; Wu EL; Rodriguez KH
[Ad] Endereço:Tulane University School of Medicine, Department of Otolaryngology/Head and Neck Surgery, New Orleans, LA, USA.
[Ti] Título:Utility of polysomnography in determination of laryngomalacia severity.
[So] Source:Int J Pediatr Otorhinolaryngol;93:145-149, 2017 Feb.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine the efficacy of polysomnography in determining the severity of laryngomalacia in pediatric patients. METHODS: Prospective cohort study. Pediatric patients referred to our pediatric otolaryngology department with a polysomnogram already performed for a presumptive diagnosis of laryngomalacia were enrolled in the study. Patients with concurrent airway lesions or neuromuscular disorders were excluded. Patients underwent history, physical exam, and flexible fiberoptic laryngoscopy. These results were used to calculate a total laryngomalacia severity score. RESULTS: 25 pediatric patients (n = 25) with an average age of 3.9 months at time of initial evaluation met criteria for enrollment in our study. 100% of patients had obstructive sleep apnea by definition. 80% of these patients underwent supraglottoplasty. The average AHI of those who underwent surgery (57.26) was not significantly different in those who underwent surgery vs. those that did not (55.43) (p = 0.41). In comparison, the average laryngomalacia severity score based from history, physical exam and flexible laryngoscopy was significantly greater in the patients that required supraglottoplasty (11.16) vs. those who did not (5.33) (p = 0.03). In addition a higher laryngomalacia severity score was not correlated with a higher AHI (p = 0.81, r = 0.08, CI: -0.5197 to 0.6235). CONCLUSION: In our cohort, polysomnography was not useful in determining the severity of laryngomalacia, did not correlate with the clinical evaluation, and alone was not predictive of the patients that would require surgical intervention. History, physical exam, and endoscopic findings remain reliable predictors of disease severity and need for operative intervention.
[Mh] Termos MeSH primário: Laringomalácia/complicações
Polissonografia
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Estudos de Coortes
Feminino
Seres Humanos
Lactente
Laringoscopia
Masculino
Anamnese
Exame Físico
Apneia Obstrutiva do Sono/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE


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[PMID]:28012601
[Au] Autor:Rathi A; Rathi S
[Ad] Endereço:Department of Otolaryngology and Head & Neck Surgery, Christian Medical College, Vellore, India. Electronic address: alokrathi14@gmail.com.
[Ti] Título:Relative imbalance as etiology of laryngomalacia - A new theory.
[So] Source:Med Hypotheses;98:38-41, 2017 Jan.
[Is] ISSN:1532-2777
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Laryngomalacia literally means weak larynx. It is the most common cause of noisy breathing in infants and children constituting around 70% of cases. Its aetiology is not clear and various theories are proposed. Treatment remains following the child with regular weight monitoring in view of expected spontaneous resolution. However we cannot predict which child will resolve spontaneously and which child may need surgical intervention. We propose a new theory based on relative imbalance of demand supply of air, suggesting the increase in demand causing turbulent airflow, increasing suction pressure and causing collapse of laryngeal structures. This theory also helps us in predicting early, which child will resolve spontaneously and which child will need surgery. The methodology to evaluate hypothesis along with techniques and tools are also suggested.
[Mh] Termos MeSH primário: Laringomalácia/etiologia
Laringomalácia/cirurgia
Laringe/fisiopatologia
Respiração
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Endoscopia
Epiglote/fisiopatologia
Refluxo Gastroesofágico/patologia
Seres Humanos
Laringoscopia
Modelos Neurológicos
Modelos Teóricos
Volume de Ventilação Pulmonar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161226
[St] Status:MEDLINE


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[PMID]:27722899
[Au] Autor:Kusak B; Cichocka-Jarosz E; Jedynak-Wasowicz U; Lis G
[Ad] Endereço:Department of Pediatrics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland. beatakusak@gmail.com.
[Ti] Título:Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions.
[So] Source:Eur Arch Otorhinolaryngol;274(3):1577-1583, 2017 Mar.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to: (1) find out whether laryngomalacia (LM) types are related to clinical course; (2) which patients with LM are at higher risk of other airway malacia [tracheomalacia (TM) and/or bronchomalacia (BM)]; and (3) evaluate the prevalence of LM in our region. Patients with established LM diagnosis and complete clinical and endoscopy records were enrolled. They were classified into different LM types according to classification based on the side of supraglottic obstruction. One hundred ten children were included. The most common LM appearance was type I-58 children, followed by combine types (I + II and I + III)-38. The other airway malacia were found in 47 patients: TM in 31, BM in 10, and TM with BM in 6. Other comorbidities (cardiac, neurological, and genetic disorders) were identified in 30 children. Patients with combine types of LM differ from those with single type of LM in terms of prematurity (13 vs 31 %, p = 0.04) and higher weight on the examination day (p = 0.006). Patients with other airway malacia differ from children with isolated LM in terms of prematurity (40 vs 13 %, p = 0.008), comorbidities (38 vs 19 %, p = 0.024), and lower weight on the examination day (p = 0.014). The prevalence of clinically relevant LM was one in 2600-3100 newborns. Clinical course of LM cannot be anticipated on the basis of solely endoscopic evaluation of the larynx. Comorbidities and prematurity increase the risk of other airway malacia. The prevalence of LM is relatively high in the middle-south part of Poland.
[Mh] Termos MeSH primário: Obstrução das Vias Respiratórias
Broncomalácia/epidemiologia
Laringomalácia
Traqueomalácia/epidemiologia
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias/patologia
Obstrução das Vias Respiratórias/fisiopatologia
Broncoscopia/métodos
Comorbidade
Feminino
Seres Humanos
Lactente
Recém-Nascido
Laringomalácia/classificação
Laringomalácia/epidemiologia
Laringomalácia/fisiopatologia
Masculino
Polônia/epidemiologia
Prevalência
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Supraglotite/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4334-5


  10 / 177 MEDLINE  
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[PMID]:27522662
[Au] Autor:Reinhard A; Gorostidi F; Leishman C; Monnier P; Sandu K
[Ad] Endereço:Department of Otorhinolaryngology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, 1011 Lausanne, Switzerland. antoine.reinhard@chuv.ch.
[Ti] Título:Laser supraglottoplasty for laryngomalacia; a 14 year experience of a tertiary referral center.
[So] Source:Eur Arch Otorhinolaryngol;274(1):367-374, 2017 Jan.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:To review the outcomes of laser supraglottoplasty performed in children with symptomatic laryngomalacia and determine the factors influencing them. We retrospectively reviewed the medical records of patients who underwent laser supraglottoplasty for symptomatic laryngomalacia at the Lausanne University Hospital from November 2001 to November 2014. We examined the patient's demography, symptoms, comorbidities, type of laryngomalacia, synchronous airway lesions, and final outcomes. Seventy-nine patients were included in this study; median age at the time of surgery was 12.7 months. 55.7 % of the cases had comorbidities, 22.8 % of the patients were premature and synchronous airway lesions were present in 32.9 % of the cases. The different morphological types of laryngomalacia (I-III) were seen in 26.6, 62 and 11.4 % of the patients, respectively. Overall, operation specific success rate of laser supraglottoplasty was 86.1 %. Failures in 11 (13.9 %) of the 79 cases required 15 revision procedures. Success rates for patients with associated comorbidities, synchronous airway lesions, neurological disorders and prematurity were 81.8, 76.9, 69.2 and 66.7 %, respectively. Patients with type III laryngomalacia had a limited success rate (66.7 %) as compared to patients with morphological types I and II (90.5 and 87.8 %, respectively). Laser supraglottoplasty is an effective and safe treatment for symptomatic laryngomalacia. Patients with prematurity, type III LM, synchronous airway lesions and associated comorbidities are predisposed to surgical failure.
[Mh] Termos MeSH primário: Laringomalácia/cirurgia
Terapia a Laser
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Comorbidade
Feminino
Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Laringomalácia/complicações
Laringomalácia/patologia
Masculino
Estudos Retrospectivos
Centros de Atenção Terciária
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160815
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4252-6



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