Discoordinate pharyngolaryngomalacia

In cases of severe laryngomalacia, laser division of the aryepiglottic folds (AEFs) or endoscopic supraglottoplasty may be an ineffective solution. Failure of this technique is rare and the reasons for failure are not well established. The purpose of this study was to describe those cases of laryngo...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 1997-02, Vol.39 (1), p.9-18
Main Authors: Froehlich, Patrick, Seid, Allan B., Denoyelle, Françoise, Pransky, Seth M., Kearns, Donald B., Garabedian, Erea N., Morgon, Alain
Format: Article
Language:English
Subjects:
BiPAP
Endoscopy
Humans
Hypoventilation
Laryngeal Diseases - physiopathology
Laryngeal Diseases - surgery
Laryngomalacia
Obstructive sleep apnea
Palate, Soft - surgery
Pharyngeal Diseases - physiopathology
Pharyngeal Diseases - surgery
Pharyngomalacia
Pharynx - physiopathology
Pharynx - surgery
Retrospective Studies
Stridor
Tracheostomy
Uvula - surgery
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Summary:In cases of severe laryngomalacia, laser division of the aryepiglottic folds (AEFs) or endoscopic supraglottoplasty may be an ineffective solution. Failure of this technique is rare and the reasons for failure are not well established. The purpose of this study was to describe those cases of laryngomalacia in which endoscopic treatment did not reverse the clinical situation. We introduce the concept of discoordinate pharyngolaryngomalacia (DPLM). DPLM was defined as severe laryngomalacia with complete supraglottic collapse during inspiration, without shortened AEFs or redundant mucosa, and with associated pharyngomalacia. Twenty-seven of 82 children with severe laryngomalacia presented a DPLM. Endoscopic treatment was performed in 16 children and the surgical procedure was inadequate to reverse the clinical problem in these patients. In 10 children correction of additional sites of obstruction was required (uvulopharyngopalatoplasty, surgery of choanal atresia, aortopexy). Tracheostomy was necessary in 13 children. Bi-level positive airway pressure (BiPAP) was used successfully in 2 children and tracheotomy was avoided. Treatment still needs to be better defined.
ISSN:0165-5876
1872-8464
DOI:10.1016/S0165-5876(96)01454-1