[Upper Airway Obstruction in a Type 4 Laryngeal Palmar in Infant].

Le Mali medical Pub Date : 2023-01-01
Mohamed Saydi Ag Med Elmehdi Elansari, Lassine Dienta, Siaka Soumaoro, Mariam Maiga, Harouna Sanogo, Boubacary Guindo, Mohamed Amadou Keita
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Abstract

Introduction: Congenital malformations of the larynx in children are often manifested by laryngeal noise (stridor), dyspnea, dysphonia and sometimes swallowing disorders. Laryngomalacia is the most common anomaly, but it is necessary to know how to look for laryngeal paralysis, congenital subglottic stenosis, sometimes a subglottic angioma or a laryngeal diastema. Endoscopy is the master examination for confirming the diagnosis and guiding the management, which may be medical and/or surgical depending on the case [1].

Objective: Aim: The aim of our work is to study the diagnostic and therapeutic particularities of a congenital malformation in an infant in a context of insufficient materials.

Observation: We report an observation of an infant aged 06 months, who was referred to us from pediatrics for chronic dyspnea with dysphonia dating back to birth without other congenital anomalies after multiple treatments without improvement based on nebulization, corticoids and antibiotics. Nasofibroscopy revealed a laryngeal web-like larynx connecting the two vocal cords on its anterior two-thirds leaving a small respiratory tract (Figure 1). The diagnosis of laryngeal palmaris was retained. Management consisted of resection during panendoscopy. Nasofibroscopy at regular intervals of up to twelve months were performed without particularity.

Conclusion: Dyspnea in infants can be frequent and have many causes. Only a thorough clinical and paraclinical examination can help to diagnose laryngeal palmaris. They are confusing to all laryngeal malformations. The prognosis can be serious if management is not carried out as soon as possible.

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[婴儿喉掌纹 4 型上气道阻塞]。
简介儿童先天性喉部畸形通常表现为喉部噪音(喘鸣)、呼吸困难、发音障碍,有时还伴有吞咽困难。喉畸形是最常见的畸形,但也有必要了解如何检查喉麻痹、先天性声门下狭窄,有时还有声门下血管瘤或喉水肿。内窥镜检查是确诊和指导治疗的主要检查手段,根据不同的病例,可以采用药物治疗和/或手术治疗[1]:目的:我们工作的目的是在材料不足的情况下研究婴儿先天性畸形的诊断和治疗特殊性:我们报告了对一名 06 个月大婴儿的观察结果,该婴儿因慢性呼吸困难和发音障碍而从儿科转诊至我院,其出生时并无其他先天性畸形,在经过雾化、皮质激素和抗生素等多种治疗后病情未见好转。鼻纤维镜检查发现,患者的喉部呈网状,连接两声带的前三分之二处留有一个小的呼吸道(图 1)。保留了喉掌状瘤的诊断。治疗包括在全内镜下进行切除。每隔 12 个月定期进行鼻纤维镜检查,无特殊情况:婴儿呼吸困难的发生率很高,原因也很多。只有全面的临床和辅助检查才能帮助诊断喉掌畸形。它们与所有喉畸形都很容易混淆。如果不尽快治疗,预后可能会很严重。
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