Consensus recommendations on the evaluation and treatment of laryngotracheal anomalies in infants and young children
-
摘要: 婴幼儿喉气道结构异常的患者在临床上表现为喘鸣、呛咳、声音嘶哑、喂养困难、间歇性青紫，以及部分患儿呼吸道梗阻导致重度的呼吸困难，甚至死亡，随之出现生长发育缓慢等健康问题，如何早期诊断与评估是儿童耳鼻喉科医生在临床上面对的极为棘手的问题。中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会联合全国多家国家或区域儿童医疗中心讨论拟定评估共识，从症状学、客观检查等方面制定出了儿童气道结构异常的评估诊断方案，为临床规范化诊疗提供指导性意见。Abstract: Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.
-
-
[1] McINTOSH R, MERRITT KK, RICHARDS MR, et al. The incidence of congenital malformations: a study of 5, 964 pregnancies[J]. Pediatrics, 1954, 14(5): 505-522. doi: 10.1542/peds.14.5.505
[2] Jefferson ND, Cohen AP, Rutter MJ. Subglottic stenosis[J]. Semin Pediatr Surg, 2016, 25(3): 138-143. doi: 10.1053/j.sempedsurg.2016.02.006
[3] Fayoux P, Daniel SJ, Allen G, et al. International Pediatric ORL Group(IPOG)Robin Sequence consensus recommendations[J]. Int J Pediatr Otorhinolaryngol, 2020, 130: 109855. doi: 10.1016/j.ijporl.2019.109855
[4] Yeung JC, Balakrishnan K, Cheng ATL, et al. International Pediatric Otolaryngology Group: Consensus guidelines on the diagnosis and management of type I laryngeal clefts[J]. Int J Pediatr Otorhinolaryngol, 2017, 101: 51-56. http://www.onacademic.com/detail/journal_1000040000826510_dfa7.html
[5] Carter J, Rahbar R, Brigger M, et al. International Pediatric ORL Group(IPOG)laryngomalacia consensus recommendations[J]. Int J Pediatr Otorhinolaryngol, 2016, 86: 256-261. doi: 10.1016/j.ijporl.2016.04.007
[6] Balakrishnan K, Sidell DR, Bauman NM, et al. Outcome measures for pediatric laryngotracheal reconstruction: International consensus statement[J]. Laryngoscope, 2019, 129(1): 244-255. doi: 10.1002/lary.27445
[7] Rosenbek JC, Robbins JA, Roecker EB, et al. A penetration-aspiration scale[J]. Dysphagia, 1996, 11(2): 93-98. doi: 10.1007/BF00417897
[8] de Trey LA, Lambercy K, Monnier P, et al. Management of severe congenital laryngeal webs-a 12 year review[J]. Int J Pediatr Otorhinolaryngol, 2016, 86: 82-86. doi: 10.1016/j.ijporl.2016.04.006
[9] Reinhard A, Gorostidi F, Leishman C, et al. Laser supraglottoplasty for laryngomalacia; a 14 year experience of a tertiary referral center[J]. Eur Arch Otorhinolaryngol, 2017, 274(1): 367-374. doi: 10.1007/s00405-016-4252-6
[10] 许政敏, 刘大波. 临床儿童耳鼻咽喉头颈外科学[M]. 北京: 人民卫生出版社, 2022: 369-371.
[11] Cohen SR. Congenital glottic webs in children. A retrospective review of 51 patients[J]. Ann Otol Rhinol Laryngol Suppl, 1985, 121: 2-16. http://europepmc.org/abstract/MED/3935032
[12] Suterwala MS, Reynolds J, Carroll S, et al. Using fiberoptic endoscopic evaluation of swallowing to detect laryngeal penetration and aspiration in infants in the neonatal intensive care unit[J]. J Perinatol, 2017, 37(4): 404-408. doi: 10.1038/jp.2016.239
[13] Myer CM 3rd, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes[J]. Ann Otol Rhinol Laryngol, 1994, 103(4 Pt 1): 319-323. http://www.onacademic.com/detail/journal_1000037791534010_52f1.html
[14] Benjamin B, Inglis A. Minor congenital laryngeal clefts: diagnosis and classification[J]. Ann Otol Rhinol Laryngol, 1989, 98(6): 417-420. doi: 10.1177/000348948909800603
[15] Yentis SM, Lee DJ. Evaluation of an improved scoring system for the grading of direct laryngoscopy[J]. Anaesthesia, 1998, 53(11): 1041-1044. doi: 10.1046/j.1365-2044.1998.00605.x
[16] Walker RD, Irace AL, Kenna MA, et al. Neurologic Evaluation in Children With Laryngeal Cleft[J]. JAMA Otolaryngol Head Neck Surg, 2017, 143(7): 651-655. doi: 10.1001/jamaoto.2016.4735
[17] Londahl M, Irace AL, Kawai K, et al. Prevalence of Laryngeal Cleft in Pediatric Patients With Esophageal Atresia[J]. JAMA Otolaryngol Head Neck Surg, 2018, 144(2): 164-168. doi: 10.1001/jamaoto.2017.2682
[18] 李辉, 季成叶, 宗心南, 等. 中国0~18岁儿童、青少年身高、体重的标准化生长曲线[J]. 中华儿科杂志, 2009, 47(7): 487-492.
-
下载:
图(5)
表(1)
计量
- 文章访问数: 1699
- PDF下载数: 568
- 施引文献: 0