预测手术干预婴儿喉软化症。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-10-03 DOI:10.1016/j.ijporl.2025.112582

Robert Brinton Fujiki , Michael D. Puricelli

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引用次数: 0

摘要

目的：喉软化症的治疗包括确定何时可以保守监测症状，何时需要手术干预以促进体重增加、呼吸功能和整体健康。本研究探讨了预测喉软化症患儿是否需要手术干预的因素。方法：采用回顾性队列设计。从一家三级儿童医院的电子病历（EMR）中确定诊断为喉软化症的婴儿。确定了两组婴儿；无手术史者（非手术组82例）和行过声门上成形术者（手术组62例）。喉软化症的诊断是由儿科耳鼻喉科医生使用远端芯片纤维喉镜确定的。从EMR中提取的数据包括患者人口统计、病史、喉软化症状、合并症、吞咽评估和喉软化相关的护理信息。结论：喉软化症患儿的手术干预可通过症状严重程度、呼吸系统疾病史、睡眠呼吸和吸吮-吞咽-呼吸协调性来预测。这些数据可以帮助临床医生确定轻度至中度喉软化患者的治疗过程。证据等级：4；

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Predicting surgical intervention in infants with laryngomalacia

Purpose

Laryngomalacia management involves determining when symptoms can be conservatively monitored and when surgical intervention is necessary to promote weight gain, respiratory function, and overall health. This study examined factors predicting the need for surgical intervention in infants with laryngomalacia.

Methods

A retrospective cohort design was employed. Infants diagnosed with laryngomalacia were identified from the electronic medical record (EMR) of a tertiary children's hospital. Two groups of infants were identified; those without any history of surgical intervention (non-surgery group = 82) and those who had undergone supraglottoplasty (surgery group = 62). Laryngomalacia diagnosis was determined by pediatric otolaryngologists using distal chip fiberoptic laryngoscopy. Data extracted from the EMR included patient demographics, medical history, laryngomalacia symptoms, comorbidities, swallow assessments, and laryngomalacia-related care information.

Results

Initial presentation of laryngomalacia symptom severity (p < .001), history of respiratory illness (e.g., pneumonia or respiratory syncytial virus; p < .001), sleep-disordered breathing (p < .001), and an uncoordinated suck-swallow-breathe pattern during feeding (p = .009) significantly predicted likelihood of supraglottoplasty. Likelihood of supraglottoplasty increased 2.8 times in infants with severe laryngomalacia symptoms (p < .001), 5.6 times in patients with sleep-disordered breathing (p < .001), and 2.5 times in those with an uncoordinated suck-swallow-breathe patterns (p < .001) when compared to patients without these conditions. On average, infants requiring supraglottoplasty reported earlier symptom onset than those not requiring surgical intervention (p = .006).

Conclusions

Surgical intervention in infants with laryngomalacia was predicted by symptom severity, history of respiratory illness, sleep breathing, and suck-swallow-breathe coordination. These data may aid clinicians in determining course of treatment for patients with mild to moderate laryngomalacia.

Level of evidence

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.