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Congenital Laryngeal Web


Presentation

  • This case presents a rare clinical finding of a type IV laryngeal web successfully repaired with a keel and subsequent long term follow up during an era when it was suggested that repair be delayed until 18 months of age at the earliest.[ncbi.nlm.nih.gov]
  • Anterior glottic web combined with epiglottic hypoplasia was found in a middle-aged man presenting with hoarseness and dyspnea on exertion. This can be considered as a unique isolated defect of the larynx during early fetal development.[ncbi.nlm.nih.gov]
  • This report presents the successful endoscopic management of a congenital laryngeal web in a 2-year-old boy, who previously underwent an uneffective scar laser transsection that led to excessive glotto-subglottic refibrosis.[ncbi.nlm.nih.gov]
  • This report presents the successful management of a congenital laryngeal web in a 10-month-old boy with endoscopic lysis and topical mitomycin-C application.[unboundmedicine.com]
Surgical Procedure
  • Surgery For some webs the correct treatment is an open surgical procedure called a larynogofissure, opening into the larynx, generally through the midline incision through the neck.[cincinnatichildrens.org]
  • A tracheostomy is a surgical procedure in which an incision is made in the front of the trachea (windpipe) to enable the person to breathe easily. It also helps to drain away any excess fluids within the throat.[medic8.com]
  • Some of the surgical procedures we offer include: Vocal cord injection , a procedure done under anesthesia that involves injecting a substance into the vocal cord to help it approximate to the opposite side.[mottchildren.org]
  • These patients can also be asymptomatic and diagnosed accidentally after difficult endotracheal intubations for surgical procedures. 3, 4 The position of the tracheal web also influences the patient’s symptoms.[pulmonarychronicles.com]
  • Posterior laryngeal clefts: preliminary report of a new surgical procedure using tibial periosteum as an interposition graft. Laryngoscope 1998; 108: 899–902. Garel C, Hassan M, Hertz-Pannier L, Francois M, Contencin P, Narcy P.[otorrinoweb.com]
Pain
  • Narrative Medicine Nephrology Neurology Neuroscience and Psychiatry Notable Notes Nursing Nutrition Nutrition, Obesity, Exercise Obesity Obstetrics and Gynecology Occupational Health Oncology Ophthalmic Images Ophthalmology Orthopedics Otolaryngology Pain[jamanetwork.com]
  • Contact Ulcers Etiology may be one of three causes Hard glottal attack Irritation as result of gastric reflux Intubation for surgery Symptoms Hoarseness/roughness of voice Laryngeal pain or pain lateralizing to ear Vocal fatigue Excessive throat-clearing[ucs.louisiana.edu]
Anemia
  • New chapters, expanded and updated coverage, increased worldwide perspectives, and many new contributors keep you current on the late preterm infant, the fetal origins of adult disease, neonatal anemia, genetic disorders, and more. "...a valuable reference[books.google.com]
Down Syndrome
  • syndrome Down syndrome Hypothyroidism Hypothyroidism Psychosocial history Psychosocial stress Psychogenic stridor TABLE 2 Historical Information in the Evaluation of Stridor in Children Historical data Possible etiology Age of onset Birth Vocal cord[aafp.org]
Laryngeal Disorder
  • Advances in the diagnosis, management, and treatment of neonates with laryngeal disorders . Seminars in Fetal and Neonatal Medicine, Vol. 21, Issue. 4, p. 270. CrossRef Google Scholar Cheng, Jeffrey and Smith, Lee P. 2016.[journals.cambridge.org]
  • CONGENITAL LARYNGEAL DISORDERS DR PRASHANTH 2. CLASSIFICATION 1. SUPRAGLOTTIS LARYNGOMALACIA LARYNGEAL CYST CONGENITAL LARYNGOCELE 2. GLOTTIS LARYNGEAL WEB CRI-DU CHAT SYNDROME VOCAL CORD PARALYSIS 3. CLASSSIFICATION CONTD…. 3.[slideshare.net]
  • […] folds fail to fully separate during the 10th week of embryonic development -May occur anywhere from anterior commissure to posterior glottis Congenital Laryngeal Web- treatment -if affecting airway, treatment is surgical -The most common congenital laryngeal[quizlet.com]
  • Laryngeal Disorders - Treatment Options Some voice disorders can be easily treated with appropriate medication, voice rest, increased hydration, and vocal hygiene. Others may require surgical intervention and/or extensive speech therapy.[texasvoicecenter.com]
  • These webs constitute a spectrum of developmental laryngeal disorders and range from a small incomplete anterior glottic web causing minimal dysphonia with extreme obstruction to a complete glottic web causing total laryngeal atresia10.[roah.ch]
Hypertension
  • Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension[jamanetwork.com]
  • Braddock SR: A new recessive syndrome with VATER-like defects, pulmonary hypertension, abnormal ears, blue sclera, laryngeal webs, and persistent growth deficiency. Am J Med Genet 2003;123A; 95–99.[karger.com]
  • Echo cardiogram read as : CHARGE association, moderate pulmonary hypertension, right pulmonary vein obstruction. Repair of unrestictive cor triatrium and closure of small secondum ASD.[roah.ch]
  • She did not have any other systemic illness such as diabetes, tuberculosis, hypertension, asthma, and arthritis. Routine laboratory data including complete hemogram, serum electrolytes, and kidney and liver function tests were normal.[annals.in]
Suggestibility
  • This case presents a rare clinical finding of a type IV laryngeal web successfully repaired with a keel and subsequent long term follow up during an era when it was suggested that repair be delayed until 18 months of age at the earliest.[ncbi.nlm.nih.gov]
  • This case and prior reports suggest that the novel approach may be effective in the treatment of laryngeal webs.[ncbi.nlm.nih.gov]
  • The flow-volume loops showed some flattening of the inspiratory and expiratory limbs, suggestive of upper airway obstruction.[pulmonarychronicles.com]
  • During the EGD, biopsies will be taken from multiple levels up and down the aero-digestive tract and these will be screened for signs of inflammation suggestive of reflux (GERD) or food allergy inflammation (eosinophilic esophagitis).[chop.edu]
  • Biphasic stridor suggests obstruction in the area between the glottis and subglottis or fixed/critical obstruction at any level. 2 Although a thorough history and physical examination may narrow differential diagnostic considerations of upper airway disease[radiologykey.com]
Agitation
  • Gain new insight into today’s hottest topics, including sleep-disordered breathing, cuffed endotracheal tubes, premedication, emergence agitation, postoperative vomiting, and new airway devices.[books.google.com]
  • The stridor is usually aggravated by respiratory tract infections and agitation. 11 Bacterial Tracheitis.[aafp.org]
  • […] location; for example, dysphagia may occur if the cyst occupies the hypopharynx (12) or if there is progressive respiratory distress until total airway obstruction, cyanosis, apnea, hoarse cry and low-pitched cry, especially with changes of position or agitation[revistas.unal.edu.co]
Stroke
  • Take advantage of a wealth of images that capture the clinical manifestations and findings associated with Kawasaki disease, lupus, lymphoma, stroke, and many other disorders seen in children.[books.google.com]

Treatment

  • The application of these minimally invasive endoscopic techniques was successful, hence it may be an effective alternative treatment option for laryngeal webs.[ncbi.nlm.nih.gov]
  • This case and prior reports suggest that the novel approach may be effective in the treatment of laryngeal webs.[ncbi.nlm.nih.gov]
  • Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout.[books.google.com]
  • Traditionally, the treatment of choice for laryngeal web is laryngofissure and placement of a stent or keel.[unboundmedicine.com]

Prognosis

  • Treatment and prognosis If symptomatic referral to an ENT surgeon for possible resection. Treatment can include various interventions via bronchoscopy, e.g.[radiopaedia.org]
  • Prognosis is good with a normal lifespan. The only noticeable long-term symptoms may be a hoarse or rough voice.[cincinnatichildrens.org]
  • Surfactant production by type II pneumocytes begins around week 20-22, but overall is not enough to prevent airway collapse (atelactstasis) Premature infants born at this stage have a VERY POOR prognosis Terminal sac period (24 weeks – birth) The overall[web.duke.edu]
  • […] can pose a real challenge to an anaesthesiologist especially in the paediatric age group.Weighing the pros and cons of a given case,the benefit of doubt should go to the patient.We decided to proceed with this case, as the child had very poor visual prognosis[roah.ch]

Etiology

  • Contact Ulcers Etiology may be one of three causes Hard glottal attack Irritation as result of gastric reflux Intubation for surgery Symptoms Hoarseness/roughness of voice Laryngeal pain or pain lateralizing to ear Vocal fatigue Excessive throat-clearing[ucs.louisiana.edu]
  • Supraglottic Abnormalities Epiglottitis Etiology: Acute bacterial epiglottitis is a potentially serious cause of upper airway obstruction in children.[radiologykey.com]
  • […] steroids (asthma meds) Fungal infections- vocal characteristics Dysphonia is proportional to the location of the fungus and extent Fungal infections- treatment -A furrow, or ridge, that runs along the membranous portion of the vocal folds -No clear etiology[quizlet.com]
  • On the basis of their etiology, they can be divided into congenital (epidermoid cysts, sulcus vocalis, vergeture, mucosal bridge) and acquired lesions (nodules, polyps, granulomas, cysts, iatrogenic scars).[giorgioperetti.it]
  • This article reviews the etiology of stridor in children and suggests an approach to evaluating and managing the problem. Etiology and Clinical Manifestations Causes of stridor in children according to the site of obstruction are listed in Table 1.[aafp.org]

Epidemiology

  • The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome. Pediatrics , 117 , 1712-21. PMID: 16651329 DOI . Aly H, Mohamed MA & Wung JT. (2017).[embryology.med.unsw.edu.au]
Sex distribution
Age distribution

Prevention

  • The laryngeal web can be successfully treated in a single stage with endoscopic lysis and topical application of mitomycin C for prevention of anterior glottic restenosis.[ncbi.nlm.nih.gov]
  • Abstract Past descriptions of the surgical treatment of congenital laryngeal webs have involved a laryngofissure to achieve division of the web and the insertion of a tantalum keel to prevent its reformation.[ncbi.nlm.nih.gov]
  • A piece of silicone membrane was inserted between the vocal cords preventing from adhesion and a silicone tube stent was also inserted into the subglottic space and trachea to keep the laryngotracheal space open widely.[jstage.jst.go.jp]
  • Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse[books.google.com]
  • Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive[jamanetwork.com]

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