An Aerodigestive Approach to Laryngeal Clefts and Dysphagia Using Injection Laryngoplasty in Young Children

Current Gastroenterology Reports
Amar MiglaniDana I Williams

Abstract

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). 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 compar...Continue Reading

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Oct 17, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Steven CoppessKaalan Johnson
Jan 24, 2019·The Laryngoscope·Reema PadiaKaalan Johnson
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May 7, 2021·American Journal of Otolaryngology·Vishnu V MarthaRobert T Sataloff
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Nov 7, 2020·International Journal of Pediatric Otorhinolaryngology·Priyanka ReddyDavid R White
Aug 16, 2021·International Journal of Pediatric Otorhinolaryngology·R E WineskiN Smith

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