Aryepiglottoplasty for laryngomalacia: the Alder Hey experience

2005 ◽  
Vol 119 (12) ◽  
pp. 958-960 ◽  
Author(s):  
J E Martin ◽  
K E Howarth ◽  
I Khodaei ◽  
A Karkanevatos ◽  
R W Clarke
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Upper Airway Obstruction ◽  
Feeding Difficulties ◽  
Choice Procedure ◽  
First Choice ◽  
Alder Hey ◽  
Tract Infections

Laryngomalacia is the most common cause of stridor in infants. Severely affected children are at risk of feeding difficulties, apnoeic episodes and cor pulmonale secondary to upper airway obstruction. The aim of this study was to assess the outcome of aryepiglottoplasty. This is a simple surgical procedure that relieves the obstruction by dividing the aryepiglottic folds. Thirty children had an aryepiglottoplasty at the Royal Liverpool Children’s Hospital between January 1995 and June 2001. The case notes of all 30 children were reviewed for age, sex, age at operation, indications, operative technique, complications and long-term outcomes. Complete resolution of stridor was obtained in 83 per cent of patients, with an improvement in a further 7 per cent. Post-operative complications included lower respiratory tract infections (13 per cent) and vomiting (7 per cent). In conclusion, simple endoscopic aryepiglottoplasty remains an effective way of treating upper airway obstruction in children. Its high resolution and low complication rate make it a safe, first choice procedure for treatment of moderate to severe laryngomalacia.

Head and Neck Manifestations of Beckwith-Wiedemann Syndrome

1995 ◽  
Vol 113 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Frank L. Rimell ◽  
Andrew M. Shapiro ◽  
David L. Shoemaker ◽  
Margaret A. Kenna
Keyword(s):  
At Risk ◽  
Airway Obstruction ◽  
Head And Neck ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Congenital Disorder ◽  
Upper Airway Obstruction ◽  
Tongue Reduction ◽  
Adenoidal Hypertrophy

Beckwith-Wiedemann syndrome is a congenital disorder manifested by organomegaly, omphalocele, hypoglycemia, and macroglossia. We have found a significant number of these children to be at risk for upper airway obstruction during infancy or childhood. In this review of 13 children, 2 required tracheotomy during infancy for cor pulmonale caused by macroglossia. Seven of nine children older than 1 year required tonsillectomy and adenoidectomy to relieve upper airway obstruction. Although macroglossia can be a cause of airway obstruction in infants with Beckwith-Wiedemann syndrome, we have found that airway obstruction during childhood is related to tonsillar and adenoidal hypertrophy and not to macroglossia. Anterior tongue reduction is reserved for the correction of malocclusion, articulation errors, or cosmesis, whereas tonsillectomy and adenoidectomy may be curative of obstructive symptoms.

Hypoventilation and cor pulmonale due to chronic upper airway obstruction

1965 ◽  
Vol 67 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Victor D. Menashe ◽  
Cyrus Farrehi ◽  
Michael Miller
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Upper Airway Obstruction

Relief of Chronic Upper Airway Obstruction Using a Dental Prosthesis: A Nonsurgical Approach

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 288-292
Author(s):  
Roland D. Eavey ◽  
Angelo Casagrande ◽  
Bruce Blasberg ◽  
Sylvan E. Stool
Keyword(s):  
Heart Failure ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Right Heart Failure ◽  
Cor Pulmonale ◽  
Upper Airway Obstruction ◽  
Management Problem ◽  
Right Heart ◽  
Alveolar Hypoventilation ◽  
Dental Appliance

The spectrum of symptoms of chronic upper airway obstruction ranges widely from merely annoying "noisy respirations" to death from heart failure secondary to cor pulmonale.1 The latter condition occurs because airway obstruction can lead to alveolar hypoventilation which results in hypoxia, hypercapnia, and acidosis which, in turn, produce pulmonary arteriolar construction.2 Chronic upper airway obstruction can also be a management problem for the pediatrician. Depending on the etiology and degree of symptoms, three treatment choices are usually considered: medical management, corrective surgery to recreate an airway; or tracheotomy to bypass the obstruction. We recently have seen a patient who demostrated chronic respiratory difficulty and ECG evidence of early right heart failure who benefited greatly by the use of a simple dental appliance.

scholarly journals Cardiorespiratory evaluation of brachycephalic syndrome in dogs

2018 ◽  
Vol 38 (6) ◽  
pp. 1130-1136 ◽  
Author(s):  
Raphaela A.M. Canola ◽  
Marlos G. Sousa ◽  
Jaislane B. Braz ◽  
Wilmer Alejandro Z. Restan ◽  
Diego I. Yamada ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Clinical Manifestations ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Indirect Measurement ◽  
Upper Airway Obstruction ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Arterial Blood ◽  
A Prospective Study

ABSTRACT: Brachycephalic syndrome (BS) in dogs is characterized by the combination of primary and secondary upper respiratory tract abnormalities and may result in significant upper airway obstruction. It can trigger inspiratory dyspnea, culminating in secondary respiratory distress, soft tissue edema, upper airway obstruction, turbulent airflow, inspiratory noise, and even death. These changes lead to increased resistance of the air passages, which can cause elevation of pulmonary pressure and clinical manifestations attributable to pulmonary hypertension. The consequence is right-sided cardiac remodeling (Cor pulmonale) with possible progression to right congestive heart failure. To investigate the effects of BS on the cardiovascular system, 28 animals were recruited for a prospective study and assigned to either the Brachycephalic Group (BG), composed of 22 French bulldogs with BS or the Control Group (CG), which was composed of 6 healthy Beagle dogs. All animals underwent a detailed physical examination, as well as laboratory analyses, electrocardiography, echocardiography, chest radiography and indirect measurement of systemic arterial blood pressure. The most relevant finding was a lower PaO2 (90.6±12.9mmHg) in BG as compared to CG (104.9±5.2), (p≤0.05), possibly attributable to hypoventilation due to anatomical alterations.

Histopathological Confirmation of Polyneuropathy in 11 Dogs With Laryngeal Paralysis

2010 ◽  
Vol 46 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Kelley M. Thieman ◽  
D.J. Krahwinkel ◽  
Michael H. Sims ◽  
G. Diane Shelton
Keyword(s):  
Airway Obstruction ◽  
Axonal Degeneration ◽  
Disease Process ◽  
Upper Airway ◽  
Nerve Fibers ◽  
Upper Airway Obstruction ◽  
Laryngeal Paralysis ◽  
Long Term Prognosis ◽  
Histopathological Studies

Acquired laryngeal paralysis (LP) is an important cause of upper airway obstruction in dogs. We hypothesize that LP may be part of a generalized polyneuropathy complex. Electro-diagnostic studies were performed in six dogs, and histopathological studies of muscle and nerve biopsies were obtained from 11 dogs diagnosed with acquired LP. Abnormalities in electrodiagnostic procedures were consistent with a generalized polyneuropathy. Loss of large-caliber nerve fibers and axonal degeneration were identified in nerve biopsies, and neurogenic atrophy was observed in muscle specimens. Abnormalities in electrodiagnostic studies and histopathology provide evidence that LP may be part of a generalized polyneuropathy. Establishing a diagnosis of a more involved disease process is relevant for long-term prognosis.

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