外科的治療を要した喉頭軟弱症の 2 例

概要

論文の詳細を見る
Laryngomalacia is one of the most common forms of laryngeal stenosis in newborns and infants. We reported two cases of laryngomalacia that were treated with surgical intervention for intractable dyspnea and dysphagia. A 4-year-old girl with complication due to cerebral palsy presented with progressive inspiratory stridor and saliva aspiration. Combined type laryngomalacia was diagnosed and she underwent a tracheotomy. A 2-year-old boy suffered from brain injury incurred from domestic violence at 4-months of age. He presented with inspiratory dyspnea followed by repeated aspiration bronchitis. Endoscopic examination revealed strongly flaccid arytenoid mucosa. The mucosal lesion was resected with a CO2 laser. A retrospective review of the charts of 13 cases of laryngomalacia in our hospital revealed that 9 cases (69%) were arytenoid type and 3 (23%) were combined type. Ten cases (77%) were complicated with central nervous system (CNS) disorders such as cerebral palsy. Besides dyspnea, swallowing disturbance was a major symptom in the cases. Generally symptoms will decrease with a physical growth; however, those cases with CNS disorders, gastroesophageal reflux, or additional laryngeal anomalies tended to have persistent symptoms. In such cases, surgical intervention might be indicated.