congenital malformation of laryngeal cartilage
Introduction
Introduction to congenital laryngeal cartilage malformation Congenital laryngeal cartilage malformation is generally divided into 3 types: 1. The epiglottis is deformed at the 5th week of the embryo. The 3rd and 4th arches fail to grow and merge from the bilateral to the midline, and the epiglottis bifurcation or splitting occurs (congenital double Epiglottis). The epiglottis fork is a snake tongue. 2, thyroid cartilage abnormal embryos at the 8th week, the two wings from the 4th zygomatic arch merged from the bottom to the midline to form thyroid cartilage. If the development is incomplete, congenital thyroid cartilage can occur, partial deficiency or cartilage softening. Causes cartilage collapse during inhalation, causing laryngeal and obstructive breathing difficulties, feasible tracheotomy. 3. At the 8th week of the abnormal cartilage of the cartilage, the annular cartilage gradually joined at the midline on the ventral side and the dorsal side. If the joint is poor and there is a crack, a congenital laryngeal spar is formed. There are also congenital hyperplasia of annular cartilage, which forms congenital throat stenosis and laryngeal atresia. basic knowledge The proportion of illness: 0.002% Susceptible people: more common in children Mode of infection: non-infectious Complications: neonatal asphyxia
Cause
Congenital laryngeal cartilage malformation
Congenital laryngeal cartilage malformations are mainly epiglottic cartilage, thyroid cartilage and cartilage deformity. Epiglottic cartilage deformities are more common in congenital laryngeal cartilage deformities. If at the 5th week of the embryo, the 3rd and 4th arches on both sides fail to fuse in the middle, it will form an episode or a congenital double epiglottis. The thyroid cartilage abnormality at the 8th week of human fetal embryo, the wing of the 4th zygomatic arch on both sides merged from the bottom to the top in the midline to form thyroid cartilage. Such as hypoplasia, can cause congenital thyroid cartilage, partial loss or cartilage softening. Abnormal congenital laryngeal cartilage abnormality At the 8th week of human fetal embryo, the left and right parts of the annular cartilage fuse at the midline. If the fusion is poor, there will be cracks and a congenital laryngeal spasm. There are also congenital hyperplasia of annular cartilage, causing congenital throat stenosis, or laryngeal atresia, breathing difficulties after birth, and even suffocation.
Prevention
Congenital laryngeal cartilage malformation prevention
Premarital examination is the first line of defense against the birth of congenital malformations.
Most congenital malformations are generally incurable once they are born, so it is very important to prevent the birth of a child. How to prevent it? Mainly through the two parts of pre-marital medical examination and prenatal diagnosis.
Amniocentesis plays a very important role in prenatal diagnosis and can diagnose thousands of diseases.
Complication
Congenital laryngeal cartilage malformation complications Complications, neonatal asphyxia
Laryngeal dysplasia, there is a fissure, called congenital laryngeal fissure, is a congenital laryngeal cartilage deformity, which has many complications of cartilage malformation, as follows:
1, epiglottis deformity: double episodes are very soft, easy to be pushed to the throat entrance when inhaling, causing difficulty breathing. Patients who are too sick of the episode, because they are soft and lean backwards, are sucked into the throat when inhaling, causing difficulty breathing. I am tired of being small and generally asymptomatic.
2. Abnormal thyroid cartilage: cartilage collapses during inhalation, causing laryngeal and obstructive breathing difficulties.
3, abnormal cartilage: caused by breathing difficulties or suffocation after birth.
Symptom
Congenital laryngeal cartilage malformation symptoms common symptoms breathing difficulties throat suffocation
1, epiglottis deformity: double episodes are very soft, easy to be pushed to the throat entrance when inhaling, causing difficulty breathing. Patients who are too sick of the episode, because they are soft and lean backwards, are sucked into the throat when inhaling, causing difficulty breathing. I am tired of being small and generally asymptomatic.
2. Abnormal thyroid cartilage: cartilage collapses during inhalation, causing laryngeal and obstructive breathing difficulties.
3, abnormal cartilage: caused by breathing difficulties or suffocation after birth.
Examine
Examination of congenital laryngeal cartilage deformity
Direct laryngoscopy is not easy for patients with acute heaviness because it can accelerate the occurrence of airway obstruction.
Indirect laryngoscopy and fiberoptic laryngoscopy are common laryngeal mucosal edema, hematoma, hemorrhage, tear, laryngeal cartilage exposure and pseudo-channel. The glottic stenosis is limited, and the vocal cord activity is limited or fixed.
The lateral lateral slice and the body slice can show the location of the laryngeal fracture and tracheal injury. Chest X-rays can show whether there is pneumothorax and emphysema.
CT scan of the neck is extremely valuable for the diagnosis of fracture, displacement and laryngeal structural deformation of the hyoid bone, thyroid cartilage and annular cartilage.
MRI of the neck is of great value in judging the damage of the throat, neck soft tissue and blood vessels.
Diagnosis
Diagnosis and diagnosis of congenital laryngeal cartilage malformation
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Laryngeal malformations caused by abnormal development of the larynx during the embryonic period are rare in the clinic, and the consequences are serious once it occurs. There are many types of congenital laryngeal malformations, including laryngeal cartilage deformity, small throat, throat or throat, subglottic stenosis, laryngeal atresia, laryngeal fissure, throat snoring, vocal cord dysplasia and sag.
1. Congenital laryngeal cartilage malformation: deformity manifested as partial or complete rupture of the epiglottis, epiglottis over or under; ectopic cartilage ectopic, unilateral or bilateral forward displacement; thyroid cartilage partially absent; Poor sexual engagement. The above malformations can cause symptoms such as eating cough, difficulty breathing, etc., and light can also have no symptoms, only found during the examination.
2. Congenital small throat; neonatal glottis is short and narrow, the anteroposterior diameter is less than 5mm, the posterior transverse diameter is less than 3mm, and the throat is narrow, called congenital small throat. A slightly smaller throat can be asymptomatic, but it is prone to symptoms of larynx obstruction when combined with respiratory infections.
3. Congenital throat or laryngeal septum: Congenital laryngeal hypoplasia, a membrane between the throat, according to the size and shape of the membrane called the throat or throat. The cause may be related to heredity. The main symptoms are low vocalization, hoarseness or loss of sound. Difficulty breathing, three concave signs when inhaling, and even suffocation and death. Symptoms vary with the size of the throat.
4. Congenital subglottic stenosis: due to congenital malformation, subglottic stenosis, diameter less than 4.5mm, easy to cause laryngeal obstruction. Severe cases of suffocation in the newborn, generally manifested as the child has difficulty breathing, but the crying is normal. The lateral radiograph shows a narrow subglottic cavity.
5. Congenital laryngeal atresia: The laryngeal development process is blocked during the embryonic period, the laryngeal cavity is not formed, and the larynx can not be ventilated due to membranous or cartilage atresia. It is manifested as a breathing action after birth, but no air inhalation, no crying; skin color is normal at birth, purpura after umbilical cord rupture. Laryngoscopy revealed a laryngeal atresia.
6. Congenital laryngeal fissure: Laryngeal dysplasia, resulting in fissures in the back of the throat. The main symptoms are throat, difficulty swallowing, and coughing. Often accompanied by lip, cleft palate, ear malformation or esophageal atresia. Laryngoscopy revealed a fissure in the intercondylar area.
7. Congenital laryngo: congenital laryngo is different from throat snoring caused by other diseases in infants and young children. It is caused by congenital larynx malformation, laryngeal cartilage softening and brainstem respiratory center development retardation. Disorder. When the child is born and after birth, he will have a throat when inhaling, accompanied by depressions in the upper clavicle. When crying and hard, the throat is aggravated, quiet and relieved after falling asleep. The crying is normal, without hoarseness. Most children with congenital throat mellitus regain self-reliance with the laryngeal cavity after two years of age, and the prognosis is good.
8. Congenital vocal dysplasia: neonatal vocal cords are poorly developed or absent, and the ventricular zone is very active or over-developed. Instead of vocal cords, it is called vocal cord dysplasia, also known as ventricular vocal dysfunction. Symptoms are silent when crying at the beginning of the birth, followed by hoarseness and rough sounds. Laryngoscopy revealed that the two sides of the chamber were close, and the ventricular band was found to be poor or absent.
9. Congenital laryngeal ptosis: the abnormal position of the congenital throat is abnormal, and the first ring of the trachea is located at the upper edge of the sternum, which is called drooping. When the neck is palpated, the laryngeal body sag and the thyroid cartilage has a low notch position. The patient's pronunciation is low and the treble is difficult.
