Synchronous airway lesions and associated anomalies in children with laryngomalacia evaluated with rigid endoscopy.
OBJECTIVE
To evaluate the prevalence of synchronous airway lesions (SALs) and associated anomalies in children with laryngomalacia requiring rigid endoscopic evaluation, the clinical significance of such lesions, and safety and outcome of selective rigid endoscopy.


METHODS
National Children's Hospital.


METHODS
Retrospective analysis. The records of all children diagnosed with laryngomalacia who underwent rigid endoscopy were identified from the surgical database over a 4-year period.


METHODS
Age at presentation, signs and symptoms at time of presentation, presence of associated neurological and/or congenital anomalies (ANCAs), presence of synchronous airway lesions, need for surgical intervention, complications and time to resolution of symptoms were assessed.


RESULTS
There were 26 children in the study. The mean age at presentation ranged from 0 to 10 months of age. One child (3.8%) required surgical intervention for severe isolated laryngomalacia. Seven children (26.9%) had at least one SAL identified. Of these, six (85.7%) were previously diagnosed on flexible fibreoptic laryngoscopy (FFL). Two of the seven children with SALs required surgical management of the SAL. Prematurity and ANCAs prolonged hospital stays in these children. However, the presence of SALs did not affect the length of hospital stay or the time to resolution of symptoms. Symptom resolved in all children by 3 years of age, whether or not SALs or ANCAs are present. There was no adverse outcome in the study group.


CONCLUSIONS
Despite having indications for rigid endoscopy, many children with laryngomalacia do not have SALs, which even when present, are rarely clinically significant. SALs and ANCAs do not impact the time to symptom resolution. The current indications for rigid endoscopy in the evaluation of laryngomalacia are appropriate and safe.
Yuen
Heng-Wai
HW
Department of Otolaryngology, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Republic of Singapore.
Tan
Henry Kun-Kiaang
HK
Balakrishnan
Abilash
A
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D020704:Laryngoscopes / Q000145:classification; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000002:abnormalities*; D008297:Male; D015995:Prevalence; D012137:Respiratory System / Q000473:pathology*; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology