• Korean Journal of Bronchoesophagology
• /
• v.4 no.1
• /
• pp.122-126
• /
• 1998

Laryngomalacia is the most common cause of inspiratory stridor and varying degrees of airway obstruction in infants but rarely occurs in children or adults. However, acquired airway obstruction would be developed due to the presence of redundant mucosa in the aryepjglottic folds similar to that seen in congenital laryngomalacia after central nervous system damage. To this condition, the term“Neurasthenic Laryngomalacia”is applied. We have recently experienced a case of neurasthenic larygomalacia, which has been managed by laser aryepiglottoplasty with good result. We report management and outcome of this patient with a review of the literatures.

• Korean Journal of Bronchoesophagology
• /
• v.3 no.1
• /
• pp.128-136
• /
• 1997

Laryngomalacia is the most common cause of stridor in infant. It is a relatively benign self-limiting condition, but in severe cases, it results in obstructive sleep apnea, cor pulmonale , gastroesophageal reflux, failre to thrive, pectus excavatum, respiratory failure and death. When the airway obstruction related to laryngomalacia becomes significant, surgical correction of the underlying laryngeal deformity is indicated. Numerous reports provide evidence to support the trimming supraglottic soft tissue by using either conventional instruments or the surgical laser for treatment of severe laryngomalacia. Recently, authors experienced a case of laryngomalacia with Trisomy 13 (Patau syndrome) which had three times respiratory arrest and was treated with laser aryepiglottoplasty. We report this case with review of the literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.1
• /
• pp.20-24
• /
• 2017

Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.

• Medical Lasers
• /
• v.10 no.4
• /
• pp.238-241
• /
• 2021

Laryngomalacia is the most common laryngeal malformation that occurs mainly in newborns and children. Symptoms include inspiratory high pitched wheezing, dyspnea, and cyanosis. In most cases, symptoms aggravate until eight months and gradually disappear without any treatment as the patient grows older, but surgical treatment is required in severe cases. The surgical treatment options include epiglottoplasty, supraglottoplasty, aryepiglottoplasty, tracheostomy, and many others performing a resection of excessive mucosa in the larynx. Unlike conventional surgeries, the authors recently treated a case of a two-month-old infant with severe laryngomalacia using a CO₂ laser. After performing CO₂ laser surgery twice, the patient was cured without complications.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.2
• /
• pp.65-67
• /
• 2007

Congenital epiglottic cyst is rare cause of stridor in neonate and if managed inadequately, disaster such as death can occur. Diagnosis of congenital epiglottic cyst includes imaging studies and endoscopy. Fiberoptic or rigid endoscopic examination excludes other causes of stridor in neonate. Complete excision of cyst is treatment of choice under suspension laryngoscopic guidance. Here, we report a case of congenital epiglottic cyst and concomitant laryngomalacia presenting with seizure and respiratory difficulty in neonate with a review of literature.

• Journal of mucopolysaccharidosis and rare diseases
• /
• v.2 no.1
• /
• pp.23-26
• /
• 2016

Mucopolysaccharidosis (MPS) I is a rare, progressive and multisystemic disease with insidious initial signs and symptoms, and making an early diagnosis can be a challenge for the first-line general medical practitioner. We report a 6-month-old girl who was brought to our well baby clinic for regular immunization with the manifestations of lumbar gibbus, hirsutism, large Mongolian spots over back and buttock, and mild bilateral legs spasticity noticed by the general pediatrician, and then newly diagnosed with MPS I after referral to the geneticist in time. Her surgical history included inguinal hernia repair at 1 month old, $CO_2$ laser supraglottoplasty for laryngomalacia and tracheostomy due to chronic respiratory failure with ventilator dependence at 2 months old. Understanding and identification of the early signs and symptoms of this disease have the potential to early diagnosis and timely appropriate treatment, which could contribute to a better clinical outcome.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.1
• /
• pp.29-32
• /
• 2007

Background and Objectives: Improvements in the fields of neonatology and surgical subspecialities make tracheotomy possible to the younger population. But complication rates for infantile tracheotomy are significantly higher than that for the other pediatric tracheotomy. This study was designed to present our 9-year experiences of infantile tracheotomy and to evaluate the effect of several factors of complications. Materials and Methods: From 1996 through 2004, 60 tracheotomies were performed. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. Results: There were 41 male patients and 19 female patients. Ventilatory support for neurological impairment(38.3%) was the leading indication for tracheotomy, followed by subglottic stenosis(36.7%), laryngomalacia(13.3%). Decannulation was accomplished in 60.0% of infants with an average of 56.5momths with tracheotomy. Complications occurred in 43.3%. There was one tracheotomy-related mortality in case of tracheal atresia. Most common complication was subglottic stenosis. Conclusion: Infantile tracheotomy had significant morbidities and its outcomes are thought to be usually related to the underlying disease and age. To prevent complication, early decannulation is advisable, and for long-term tracheotomy patients, regulation of reflux and infection may be necessary.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.12 no.2
• /
• pp.92-95
• /
• 2016

Beckwith-Wiedemann syndrome comprises multiple congenital anomalies with a risk of development of childhood tumors. Macroglossia is the predominent finding in Beckwith-Wiedemann syndrome and other findings include postnatal somatic gigantism, abdominal wall defects, nevus flammeus of the face, congenital heart defects, and cleft palate. The aim of this case presentation is to describe the dental treatment of a child with Beckwith-Wiedemann syndrome. A 3-year-old boy with Beckwith-Wiedemann syndrome visited to the Seoul National University Dental Hospital for dental evaluation and treatment. Due to the multiple caries and poor cooperation, we planned to perform the dental procedure under general anesthesia. The dental procedure was successfully performed and there was no airway complications after extubation. This case suggests that general anesthesia may be useful for the patient with uncooperative Beckwith-Wiedemann syndrome, since macroglossia and laryngomalacia may exacerbates airway compromise during dental sedation.

• Clinical and Experimental Pediatrics
• /
• v.51 no.7
• /
• pp.775-779
• /
• 2008

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.2
• /
• pp.116-121
• /
• 2008

Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.