Histological insight into the pathogenesis of severe laryngomalacia

Objective: To correlate clinical and histological findings in patients with laryngomalacia who required surgical intervention. Methods: Retrospective study of all patients undergoing supraglottoplasty by a single surgeon (MEG) for severe laryngomalacia between October, 1999 and November, 2000. Resul...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2001-10, Vol.61 (1), p.31-38
Main Authors: Chandra, Rakesh K., Gerber, Mark E., Holinger, Lauren D.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Epiglottis - surgery
Female
Gastroesophageal reflux
Gastroesophageal Reflux - etiology
Humans
Infant
Infant, Newborn
Laryngeal Diseases - complications
Laryngeal Diseases - pathology
Laryngeal Diseases - surgery
Laryngeal dystonia
Laryngeal histology
Laryngeal Mucosa - pathology
Laryngomalacia
Male
Medical sciences
Neuromuscular Diseases - complications
Non tumoral diseases
Otorhinolaryngology. Stomatology
Pediatric laryngology
Respiratory Sounds - etiology
Retrospective Studies
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Objective: To correlate clinical and histological findings in patients with laryngomalacia who required surgical intervention. Methods: Retrospective study of all patients undergoing supraglottoplasty by a single surgeon (MEG) for severe laryngomalacia between October, 1999 and November, 2000. Results: Nine patients were identified, of which seven had clinical evidence of GER. Seven patients had co-existing abnormalities or delays of neuromuscular development including seizure disorder, agenesis of the corpus callosum, obstructive sleep apnea, primary aspiration, a history of apparent life-threatening events, and craniosynostosis. Varying degrees of subepithelial edema and significant dilation of the subepithelial lymphatics were noted in all specimens. Submucosal inflammation was minimal to mild, and intraepithelial inflammation was rare to absent in all sections. No submucosal gland hyperplasia was seen in the samples from any patient. Two specimens contained cuneiform cartilage, both of which were histologically characterized as fibrocartilage. Conclusions : In this series, the histopathology of tissue excised during the treatment of severe laryngomalacia was dominated by submucosal edema and lymphatic dilation. Further study is needed to investigate comorbidities that may contribute to the need for intervention in children with laryngomalacia.
ISSN:0165-5876
1872-8464
DOI:10.1016/S0165-5876(01)00541-9