Clinical factors associated with surgical intervention and outcomes in pediatric laryngomalacia: A five-year tertiary care study from Eastern India

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2026-07-01 Epub Date: 2026-06-06 DOI:10.1016/j.amjoto.2026.104868

Partha Pratim Halder, Parinita Ranjit, Barnali Ghosh Das, Pallavi Agarwal

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引用次数: 0

Abstract

Objective

To evaluate clinical characteristics, associated comorbidities, management strategies, and factors associated with surgical intervention in children with laryngomalacia managed at a tertiary pediatric airway referral center in Eastern India.

Methods

This retrospective cohort study included children aged 0–60 months diagnosed with laryngomalacia between January 2019 and December 2024 at Institute of Child Health. Diagnosis was confirmed by flexible nasopharyngolaryngoscopy. Clinical features, disease severity, feeding dysfunction, gastroesophageal reflux disease (GERD), synchronous airway lesions (SALs), management details, and outcomes were analyzed. Additional variables were extracted from institutional records following peer-review recommendations to improve methodological reporting. Factors associated with surgical intervention were evaluated using univariate analysis and exploratory multivariable analysis where statistically feasible.

Results

A total of 68 children were included (male:female ratio 1.9:1). Median age at symptom onset was 2.5 months (IQR 1.5–4.0 months), and median age at diagnosis was 5 months (IQR 3–7 months). Feeding difficulty occurred in 47.1%, aspiration in 17.6%, failure to thrive in 22.1%, GERD in 30.9%, and SALs in 26.5%. Most children (82.4%) were successfully managed conservatively, while 17.6% required Supraglottoplasty. Fifty-nine children (86.8%) completed at least 12 months follow-up. Complete resolution of stridor occurred in 48/59 children (81.4%), and surgical success was observed in 10/12 children (83.3%). Feeding dysfunction and SALs were significantly associated with surgical intervention.

Conclusions

Most children with laryngomalacia improve with conservative management. However, feeding dysfunction and synchronous airway lesions may identify children at higher risk of requiring surgery. Early multidisciplinary airway evaluation may improve outcomes.

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与小儿喉软化症手术干预和预后相关的临床因素：一项来自印度东部的五年三级保健研究。

目的：评估印度东部某三级儿科气道转诊中心喉软化症患儿的临床特征、相关合并症、管理策略和手术干预相关因素。方法：本回顾性队列研究纳入了2019年1月至2024年12月在儿童健康研究所诊断为喉软化症的0-60个月儿童。经柔性鼻咽喉镜检查确诊。分析临床特征、疾病严重程度、进食功能障碍、胃食管反流病（GERD）、同步气道病变（SALs）、治疗细节和结局。根据同行评议建议，从机构记录中提取了其他变量，以改进方法学报告。在统计可行的情况下，采用单因素分析和探索性多变量分析评估与手术干预相关的因素。结果：共纳入68例患儿，男女比例为1.9:1。症状出现时的中位年龄为2.5个月（IQR为1.5-4.0个月），诊断时的中位年龄为5个月（IQR为3-7个月）。进食困难（47.1%）、误吸（17.6%）、茁壮成长失败（22.1%）、GERD（30.9%）和SALs（26.5%）。大多数患儿（82.4%）保守治疗成功，17.6%患儿需要进行喉上成形术。59名儿童（86.8%）完成了至少12个月的随访。48/59例患儿喘鸣完全消失（81.4%），10/12例患儿手术成功（83.3%）。喂养功能障碍和SALs与手术干预显著相关。结论：大多数喉软化患儿经保守治疗后病情好转。然而，喂养功能障碍和同步气道病变可能是需要手术的高风险儿童。早期多学科气道评估可改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

期刊介绍： Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.