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Congenital laryngomalacia is related to exercise-induced laryngeal obstruction in adolescence.

Abstract：

OBJECTIVES:Congenital laryngomalacia (CLM) is the major cause of stridor in infants. Most cases are expected to resolve before 2 years of age, but long-term respiratory prospects are poorly described. We aimed to investigate if CLM was associated with altered laryngeal structure or function in later life. METHODS:Twenty of 23 (87%) infants hospitalised at Haukeland University Hospital during 1990-2000 for CLM without comorbidities and matched controls were assessed at mean age 13 years. Past and current respiratory morbidity was recorded in a questionnaire, and spirometry performed according to standard quality criteria. Laryngoscopy was performed at rest and continuously throughout a maximal treadmill exercise test (continuous laryngoscopy exercise test (CLE-test)), and scored and classified in a blinded fashion according to preset criteria. RESULTS:In the CLM group, laryngeal anatomy supporting CLM in infancy was described at rest in nine (45%) adolescents. Eleven (55%) reported breathing difficulties in relation to exercise, of whom 7 had similarities to CLM at rest and 10 had supraglottic obstruction during CLE-test. Overall, 6/20 had symptoms during exercise and similarities to CLM at rest and obstruction during CLE-test. In the control group, one adolescent reported breathing difficulty during exercise and two had laryngeal obstruction during CLE-test. The two groups differed significantly from each other regarding laryngoscopy scores, obtained at rest and during exercise (p=0.001 or less). CONCLUSIONS:CLM had left footprints that increased the risk of later exercise-induced symptoms and laryngeal obstruction. The findings underline the heterogeneity of childhood respiratory disease and the importance of considering early life factors.

journal_name

Arch Dis Child

journal_title

Archives of disease in childhood

authors

Hilland M,Røksund OD,Sandvik L,Haaland Ø,Aarstad HJ,Halvorsen T,Heimdal JH

doi

10.1136/archdischild-2015-308450

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

443-8

issue

eissn

0003-9888

issn

1468-2044

pii

archdischild-2015-308450

journal_volume

101

pub_type

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Congenital laryngomalacia is related to exercise-induced laryngeal obstruction in adolescence.