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An Aerodigestive Approach to Laryngeal Clefts and Dysphagia Using Injection Laryngoplasty in Young Children.
Miglani, Amar; Schraff, Scott; Clarke, Pamela Y; Basharat, Usmaan; Woodward, Peter; Kang, Paul; Stevens, Lindsay; Woodward, Jim; Williams, Howard; Williams, Dana I.
Afiliación
  • Miglani A; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA.
  • Schraff S; Arizona Otolaryngology Consultants, Phoenix, AZ, USA.
  • Clarke PY; Department of Gastroenterology, Aerodigestive Program, Phoenix Children's Hospital, Phoenix, AZ, USA.
  • Basharat U; University of Arizona College of Medicine, Phoenix, AZ, USA.
  • Woodward P; Department of Pulmonology, Phoenix Children's Hospital, Phoenix, AZ, USA.
  • Kang P; Department of Epidemiology and Biostatistics, University of Arizona College of Public Health, Phoenix, AZ, USA.
  • Stevens L; Department of Gastroenterology, Aerodigestive Program, Phoenix Children's Hospital, Phoenix, AZ, USA.
  • Woodward J; Department of Pulmonology, Phoenix Children's Hospital, Phoenix, AZ, USA.
  • Williams H; Department of Anesthesiology, Valley Anesthesia and Phoenix Children's Hospital, Phoenix, AZ, USA.
  • Williams DI; Department of Gastroenterology, Aerodigestive Program, Phoenix Children's Hospital, Phoenix, AZ, USA. DUrsea@phoenixchildrens.com.
Curr Gastroenterol Rep ; 19(12): 60, 2017 Nov 06.
Article en En | MEDLINE | ID: mdl-29105033
PURPOSE OF REVIEW: Our objective is to summarize the presentation, diagnosis, and management of mild laryngeal clefts in children. We focus on deep interarytenoid notches (DIN), a subclassification of type 1 laryngeal clefts (LC1), and review the literature and our multidisciplinary experience utilizing injection laryngoplasty (IL). RECENT FINDINGS: DIN is a mild form of LC1 and is considered a normal anatomical variant. Recent cohort studies demonstrate IL to be a safe, low-risk, and efficacious treatment of LC1, but few studies focus on DIN. We present results from two aerodigestive clinic (ADC) pilot studies at our institution, in patients 1-3 years old, with DIN-related dysphagia and aspiration (DA). Feeding, respiratory-related symptom scores, and aspiration/penetration assessed on modified barium swallow (MBS) significantly improved following combined IL and feeding therapy using a thickener weaning protocol (TWP). Subgroup analysis reveals combined IL and TWP to be particularly effective in patients with severe baseline DA. Multidisciplinary aerodigestive evaluation and management with IL and feeding therapy focused on weaning levels of thickener is emerging as a novel and effective approach for treatment of DIN-related DA in young children. Further comparative, prospective trials investigating effects of IL and feeding therapy are required to validate results.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Anomalías Congénitas / Trastornos de Deglución / Laringoplastia / Laringe Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Curr Gastroenterol Rep Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Anomalías Congénitas / Trastornos de Deglución / Laringoplastia / Laringe Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Curr Gastroenterol Rep Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos