[Treatment laryngomalacia: experience with 22 cases].
Laryngomalacia is the most frequent cause of stridor in childhood, and in most of the cases, spontaneous resolution occurs by the age of 2 years. Approximately 10% of the cases (severe laryngomalacia) require surgery. This condition is of unknown etiology and its diagnosis is made by fiberoptic laryngoscopy, which shows shortening of the aryepiglottic folds, and/or redundant arytenoid mucosa, and/or anterior-posterior epiglottic prolapse.


OBJECTIVE
Our objective was to verify the main clinical and anatomical affections and to highlight the clinical parameters for clinical follow-up and surgical indication in patients with laryngomalacia.


METHODS
Transversal cohort study.


METHODS
Twenty-two children diagnosed with laryngomalacia in the Pediatric Otorhinolaryngology of UNIFESP-EPM, from January 2001 to December 2003, whose clinical and surgical follow-up were performed by the same examiner, were enrolled in this study.


RESULTS
Out of twenty-two evaluated children, 2 (9.1%) presented with severe laryngomalacia and pectus excavatum (funnel chest). At polysomnography, no child presented any significant respiratory event during sleeping. Those two children with severe laryngomalacia were submitted to supraglottoplasty with resection of the aryepiglottic folds.


CONCLUSIONS
We concluded that stridor and shortening of the aryepiglottic folds are preponderant in children with laryngomalacia. The polysomnographic exam did not prove to be a good parameter for clinical follow-up, neither for surgical indication. The most important parameters were pectus excavatum and failure to thrive. Supraglottoplasty is effective with low rate of morbidity.
Avelino
Melissa A G
MA
Universidade Federal de São Paulo, Escola Paulista de Medicina. melissa.avelino@uol.com.br
Liriano
Raquel Y G
RY
Fujita
Reginaldo
R
Pignatari
Shirley
S
Weckx
Luc L M
LL
D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004825:Epiglottis / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000175:diagnosis; D005931:Glottis / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D017286:Polysomnography; D012135:Respiratory Sounds / Q000175:diagnosis; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis; D016896:Treatment Outcome; D015430:Weight Gain