Laryngomalacia
Characterized by flaccidity of supraglottic structures, it is the commonest laryngeal stridor (60%-70%).
Pathology:
?Softness or flabbiness and lack of consistency of the larynx.
??Thinning and hypocellularity of the laryngeal cartilage.
???Wrinkled loose mucosa especially over the arytenoids cartilage.
Clinical features:
?Stridor is high pitch inspiratory stridor which is present at birth and become obvious when the child become active or have URTI.The stridor start to increase at the first 8 months and become maximum at 9-12 months,it is intermittent, during feeding or crying and more obvious during sleep especially when the child lies on his back, on hyperextension of the neck the stridor will decrease.
??Long and narrow epiglottis prolapsed backwards with omega shape ( ? )
???Small,lax laryngeal inlet lead to sucked together by each inspiration.
????The suprsglottis is deepened and narrow and the vocal cords are difficult to see
????Elongated arytenoids car.covered by loose redundant mucosa and on inspiration. Crossing one over the other.
Treatment:
Most cases disappear spontaneously between 18 months to 2 years, if the child is with feeding difficulty. Failure to thrive or respiratory distress this needs active treatment which is:
? Tracheostomy
?? Excision of the redundant mucosa
??? Division of aryepiglotic fold
Other congenital abnormality of the larynx:
?Subglottic stenosis
??Subglottic haemangioma
???Laryngeal web
????Laryngeal cyst
Intubation granuloma
This injury mostly occur in patient mostly have a traumatic intubation due to rough intubation,prolong intubation,or use of large size tube.
Clinical features:
Patient presented with hoarseness of voice few days or weeks after an operation, and rarely presented with stridor.
On examination by indirect laryngoscope or by endoscope, large fleshy granuloma arising from one arytenoids if not treated may lead to fibrosis.
Treatment:
?Voice rest
??Endoscopic removal of granuloma
Vocal cord nodule (Singer s nodule)
It is due to misuse of voice and bad voice production common in school children.teacher, singers and actors, often in the presence of inflammation.
Pathology:
Localised hard thickening on the edge of each vocal cord at the junction of anterior thirds and posterior two third of vocal cord,it is usually bilateral.
Clinical features
Hoarseness of voice, with voice fatigue
Treatment
?voice rest
??Removal of any inflammatory focus
???Speech therapy often lead to resorption of the nodules
????Finally, precise localised removal is curative.
المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .