congenital laryngeal web
Introduction
Introduction to congenital throat There is a congenital membrane between the larynx, called congenital throat, and the larger part of the larynx is called the laryngeal septum. The cause of this is related to abnormal embryonic development. When the embryo is 30mm, the closed epithelium between the original glottis begins to absorb and re-establish the pipeline. If the absorption is incomplete, the congenital throat at the glottis can be formed. The thickness of the throat is different, it is connective tissue, there are a few hair cell blood vessels, the epithelial layer of the mucous membrane of the throat, the throat of the throat, the glottis and the subglottic, which are more common in the glottic area. There are very few cases that occur above and below the glottis. basic knowledge The proportion of illness: 0.0035% Susceptible people: good for infants and young children Mode of infection: non-infectious Complications: respiratory failure
Cause
Congenital throat cause
When the embryo is 30mm, the 4th and 5th pairs of the zygomatic arch each form a bulge, and then the lumen of the upper part of the larynx gradually opens and forms the larynx and vocal cords. If the development is restricted in this period, the two vocal cords are not Can separate to form a throat.
Prevention
Congenital throat prevention
The laryngologist should cooperate with the examination, treatment and follow-up to prevent missed diagnosis and delayed treatment of secondary laryngeal. In the operation, due to thicker adhesions and more bleeding, the baseline of the vocal cords and membrane must be distinguished before surgery, laser or microwave. The hemostatic effect is better, but pay attention to the burning surface not to be wide, not deep, so as not to cause postoperative adhesion again, systemic or local hormonal application has a certain effect on reducing adhesion, and regular postoperative review should be necessary, there are multiple throats The diagnosis of traumatic throat is easier to diagnose. The glottis of the primary lesions often have adhesions, and the adhesion range is developed under the glottis and the posterior glottis. The difficulty of surgery is bigger, so prevention is the key. It is recommended that when performing laryngeal surgery, the surgeon must be gentle in movement, do not damage the face too wide, do not damage the joint before, do not deepen the laser or microwave treatment, pay attention to shorten the review time of the child, master the best surgical timing, may reduce the recurrence opportunity.
Complication
Congenital throat complications Complications, respiratory failure
If the throat is moderately large, the throat can still be ventilated, but the voice is hoarse, with inspiratory dyspnea. If the throat is small, the crying is low and dumb, and there is no obvious difficulty in breathing. Adults and children have no obvious throat. Symptoms, occasional hoarseness or pronunciation are prone to fatigue, and there is a feeling of poor breathing during strenuous activities.
Symptom
Congenital throat symptoms common symptoms purpura dyspnea hoarseness
Neonatal and infants must be diagnosed by direct laryngoscopy. Children or adults with throat may be diagnosed by indirect laryngoscopy or fiberoptic laryngoscopy. Under the laryngoscope, there may be a diaphragm or septum in the laryngeal cavity, which is white or reddish. The trailing edge is neat, mostly curved, a few are triangular, and the air is flat when inhaling, but when the crying or the pronunciation glottis is closed, the squat hides downward or protrudes upward like a glottis mass.
Congenital throat in infants should be differentiated from other congenital laryngeal abnormalities, such as congenital subglottic obstruction and congenital throat, and children or adults should be identified as congenital or acquired according to their medical history. Patients with congenital throat are often accompanied by congenital anomalies in other areas and should be noted during diagnosis.
The throat of an infant is different from the symptoms of a child or an adult's throat. The symptoms vary with the size of the throat. Children with a wide range of throats have no cries after birth, have difficulty breathing or suffocation, and have a snoring throat. Beep, there is a laryngeal obstruction during inhalation, often with cyanotic and not milky symptoms. The middle of the throat is large, the throat is still ventilated, but the voice is hoarse, with inspiratory dyspnea, and the throat is small. However, the crying is low and dumb, and there is no obvious difficulty in breathing. Adults and children generally have no obvious symptoms in their throats, occasionally hoarseness or pronunciation is easy to feel tired, and there is a feeling of poor breathing during strenuous activities.
Examine
Congenital throat examination
Direct laryngoscopy should be performed. It can be seen that the gray or white red enamel film is connected to the front end of the vocal cords on both sides, and the trailing edge is semi-circular. When the sound is pronounced, the film is wrinkled and squeezed on the upper or lower part of the vocal cords. When the gas is released, it is formed into a film. The throat occurs mostly between the vocal cords. It can also occur under the glottis or on the glottis. It is rare in the back of the throat.
Diagnosis
Diagnosis and diagnosis of congenital throat
Identification with neonatal asphyxia:
Diagnosis is mainly made by medical history and clinical manifestations. In recent years, the fetal heart rate monitoring and fetal scalp capillary blood pH measurement (normal fetal scalp blood pH minimum value of 7.25, if pH <7.15 indicates fetal asphyxia) to find the fetus asphyxia.
