Application Of Bronchoscopy In 48 Children With Congenital Laryngeal Stridor

Objection:To explore the clinical characteristics,etiological analysis,diagnosis and treatment of congenital laryngeal stridor and the diagnostic value of bronchoscopy in children with congenital laryngeal stridor,and to explore the therapeutic effect of bronchoscopy on children with congenital laryngeal stridor caused by different etiologies.Methods:From June 2017 to June 2018,48 children were admitted to the First Hospital of Jilin University.All children were diagnosed as congenital laryngeal stridor by electronic bronchoscopy.The development of larynx and trachea can be visually understood by bronchoscope,and the etiology of congenital laryngeal stridor can be analyzed.At the same time,bronchoscope and its interventional techniques can be used to treat different etiologies,and they can be reexamined within one week to two years,respectively.The clinical data of 48 children with congenital laryngeal stridor were retrospectively analyzed,including general data(age,sex),clinical symptoms,signs,pathological features,treatment and prognosis.Results:1.Gender and age: 48 children were diagnosed as congenital laryngeal stridor after bronchoscopy,including 36 boys and 12 girls,More boys than girls,aged from 1 day to 36 months,with an average age of 8.2 months.The highest incidence was in 0-6 months.2.The clinical manifestations were varied,Among them,there were 48 cases of laryngitis,30 cases of choking milk,16 cases of cough,15 cases of feeding difficulties,8 cases of dyspnea,5 cases of malnutrition,3 cases of snoring,2 cases of skin cyanosis,2 cases of shortness of breath and 1 case of nasal obstruction.Its clinical manifestation can exist either alone or at the same time.At this time,we should be more vigilant in clinic.Children with suspected congenital laryngeal stridor should be detected,diagnosed and treated early.3.Bronchoscopic examination: The application of bronchoscopy in children with congenital laryngeal stridor is more and more extensive.The causes of laryngeal wheezing after bronchoscopic examination are clear,and the manifestations of different causes are different.The causes of laryngeal wheezing are not single,but there are several causes which can cause laryngeal wheezing symptoms at the same time.Laryngeal softening is still the most common cause.The remaining causes are posterior pharyngeal cavity softening,tongue root cyst,gastroesophageal reflux,tracheal stenosis,tracheomalacia,limited epiglottic activity,lingual root retrograde drop,Throat puff,subglottic,supraspinal granulation hyperplasia and meningocele.4.After bronchoscopy,according to the different causes of laryngeal wheezing,the treatment methods are also different.Of 48 cases,29 were treated,including holmium laser epiglottoplasty under bronchoscope,tongue cyst ablation under general anesthesia,laryngeal function reconstruction,silicone stent implantation under bronchoscope and balloon dilatation.After treatment,the symptoms of 29 children were alleviated.Untreated children were discharged from hospital after being diagnosed by bronchoscopy during hospitalization.Among 19 untreated children,3 family members disagreed with the treatment.After six months of follow-up,2 cases had no improvement in symptoms and 1 case was lost to follow-up.The remaining 16 cases had mild to moderate laryngeal softening without treatment.After six months of follow-up,13 cases had improvement in symptoms and 3 cases were lost to follow-up.Conclusion:1.Congenital laryngeal stridor as a syndrome,its main symptoms of consultation show diversity,can exist alone,can also coexist with a variety of symptoms.2.The etiology of congenital laryngeal stridor is complex.Bronchoscopy has a significant advantage in the etiological diagnosis of congenital laryngeal stridor.3.Bronchoscopic interventional therapy should be performed as early as possible for moderate to severe laryngomalacia,tongue root cyst,tracheal stenosis and severe tracheomalacia.