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External traumas to the paediatric larynx include blunt and penetrating injuries, inhalation injuries and injuries from caustic ingestion. They are classified depending on the site [3, 21, 22], severity [23] and type of tissue injuries [28].
Benign and malignant neoplasms of the larynx and trachea are rare entities, accounting for only 2% of the pathologies reported by PH Holinger in a large series of 846 paediatric laryngeal anomalies [8]. Although benign tumours largely outweigh their malignant counterparts by a ratio of 98% to 2%, they can be very challenging for the otolaryngologist.
Laryngomalacia (LM) is the most common cause of congenital stridor in infants, accounting for approximately 60% (range 50–75%) of all congenital laryngeal anomalies [8, 16]. Boys are affected twice as often as girls.
In the paediatric population, BVCP is the second most common congenital laryngeal anomaly, and its prevalence (∼10–15%) in newborns is four to six times lower than that of laryngomalacia (∼60% of the cases). A mild inspiratory stridor along with a hoarse, breathy cry and feeding difficulties (aspiration) are suggestive of UVCP. In contrast, a high-pitched inspiratory stridor with a normal voice, apnoeic...
Congenital subglottic stenosis (C-SGS) is defined as a restriction of the subglottic diameter to less than 4.0 mm in a full-term neonate and 3.0 mm in a premature baby [16]. It is the third most common congenital anomaly of the larynx [13] after laryngomalacia and vocal cord paralysis, and the most common laryngeal anomaly necessitating tracheotomy in children under 1 year of age [15]. Its true prevalence...
Anterior laryngeal webs are uncommon (∼5%) congenital anomalies resulting from a recanalisation failure of the primitive larynx during the eighth and tenth week of embryological development. In fact, they share the same pathogenesis as C-SGS and may be considered as a subgroup of this entity. This explains why the most severe types of glottic webs are associated with a cartilaginous SGS. If the process...
Approximately 60% of infantile haemangiomas are located in the head and neck regions [10], where they represent the most common tumours in paediatric patients. In contrast, subglottic haemangiomas (SGH) are rare benign tumours of the airway, accounting for only 1.5% of all congenital laryngeal anomalies [11]. When airway symptoms suggestive of a laryngeal pathology are associated with cutaneous haemangiomas...
Ductal cysts are the most common cysts found in the pharyngolaryngeal region. They result from the retention of mucus due to obstruction of the mucus gland duct, leading to a mucus retention cyst [9, 12, 13]. Depending on their location (subglottis or pharyngolarynx), ductal cysts may provoke upper airway obstruction [1] (Fig.11.1) and generate symptoms that are similar to saccular cysts or laryngoceles.
A posterior laryngeal cleft (LC) may be limited to the interarytenoid region or involve the cricoid lamina. When the cleft is more extensive and reaches the cervical or intrathoracic trachea, it is termed a laryngo-tracheo-oesophageal cleft (LTOC). This condition is very uncommon, accounting for only 0.5–1.5% of all congenital laryngeal anomalies [8, 10]. When taking into account the minor cases that...
Congenital tracheal anomalies are rare entities, accounting for 0.3–1% of all laryngotracheal stenoses [75], with an incidence estimated to be approximately 1:60,000 live births [42]. Experience managing these anomalies is consequently limited and widely dispersed.
Paediatric laryngotracheal stenosis (LTS) encompasses a variety of congenital and acquired conditions that require precise assessment and tailored treatment for each individual patient. About 90% of acquired conditions are represented by subglottic stenosis (SGS) resulting as a complication of tracheal intubation [1, 14]. In this case, medical history often includes an extubation failure following...
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