The role of laryngeal ultrasound in diagnosis of infant laryngomalacia. (September 2019)

• Record Type: Journal Article
• Authors: Huang, Huilian; Xia, Chunxia; Hu, Minxia; Ma, Teng; Zhu, Qiang; Zhao, Hanxue
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 124(2019:Sep.)
• Page Start: 111
• Page End: 115
• Publication Date: 2019-09
• Subjects: Laryngomalacia -- Infant -- Ultrasound -- Diagnosis; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2019.05.043
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objective: The purpose of this study was to evaluate the role of laryngeal ultrasound in diagnosis of infant laryngomalacia. Methods: Forty consecutive infant patients with inspiratory stridor or other laryngeal symptoms underwent flexible fiberoptic nasopharyngolaryngoscopy and laryngeal ultrasound examination from January 2014 to May 2014. The curling angle of the epiglottis and/or arytenoid tissue collapses on laryngeal ultrasound during inspiration were used to diagnose infant laryngomalacia. The value of laryngeal ultrasound in diagnosis of infant laryngomalacia was evaluated and further compared to that of flexible fiberoptic nasopharyngolaryngoscopy. Results: The mean angle of the curling epiglottis in 26 patients with laryngomalacia was 69.1 ± 8.1 degrees, while the mean angle of the slightly curling epiglottis in 12 patients without laryngomalacia was 89.6 ± 9.7 degrees ( p < 0.0001). Arytenoid tissue collapses were found in 24 patients with laryngomalacia and only one patient without laryngomalacia had a local collapse of arytenoid tissue ( p < 0.0001). Twenty six of the 28 patients with laryngomalacia diagnosed by flexible fiberoptic nasopharyngolaryngoscopy were detected by laryngeal ultrasound. There was an excellent consistency between laryngeal ultrasound and flexible fiberoptic nasopharyngolaryngoscopy in the detection of infant laryngomalacia (κ = 0.826). Laryngeal ultrasound had a sensitivity of 96.3%, a specificity of 84.6%, a positive predictive value of 92.9%, and a negative predictive value of 91.7% in diagnosing infant laryngomalacia. Conclusions: Laryngeal ultrasound can help diagnose infant laryngomalacia through visualizing omega-shaped epiglottis and/or arytenoid tissue collapse during inspiration. The modality has an excellent consistency with flexible fiberoptic nasopharyngolaryngoscopy in diagnosis of the disease.