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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Epiglottic and base-of-tongue prolapse in children: grading and management.
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Epiglottic and base-of-tongue prolapse in children: grading and management.

机译：儿童会厌和舌基脱垂：分级和管理。

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OBJECTIVES: A distinct entity of airway obstruction from epiglottic and base-of-tongue (EBT) prolapse in the pediatric population is defined. Laryngopharyngeal findings, swallowing dysfunction, and gastroesophageal reflux disease are described in a group of children with EBT prolapse. A new grading system is also presented. STUDY DESIGN: A prospective study was conducted of laryngopharyngeal findings in children with EBT prolapse, a description of a new grading system, and review of the pediatric literature. METHODS: Fourteen children with EBT prolapse were prospectively studied with flexible fiberoptic nasopharyngolaryngoscopy. A new grading system for EBT prolapse was developed. Grade 0 is a normal airway. Grade 1 is prolapse of the epiglottis against the posterior pharyngeal wall but with normal position of the tongue. Grade 2 is prolapse of the epiglottis and base of tongue with only the epiglottic tip visible. Grade 3 is glossoptosis with no portion of the epiglottis visible. The diagnostic modalities and treatments for EBT prolapse are reviewed. RESULTS: Of the 14 children studied, seven (50%) had grade 1, four (29%) had grade 2, and three (21%) had grade 3 EBT prolapse. Swallowing dysfunction (five of 14, 38%) and gastroesophageal reflux disease (13 of 14, 93%) were also prevalent. CONCLUSION: The new grading system was applied successfully to describe the severity and sites of airway obstruction in 14 children with EBT prolapse. Swallowing dysfunction and gastroesophageal reflux disease occur in this population. Although surgical therapies are sometimes effective, lack of consistent success and the risk of aspiration with procedures other than tracheotomy may lead some to conclude that continuous positive airway pressure or tracheotomy are the safest options.
机译：目的：确定了儿科人群中会厌和舌基（EBT）脱垂所致气道阻塞的独特实体。一组EBT脱垂儿童描述了喉咽发现，吞咽功能障碍和胃食管反流疾病。还提出了一种新的分级系统。研究设计：对EBT脱垂儿童的喉咽发现进行了前瞻性研究，描述了新的分级系统，并回顾了儿科文献。方法：对14例EBT脱垂患儿进行了柔性纤维鼻咽喉镜检查。开发了新的EBT脱垂分级系统。 0级是正常的气道。 1级是会厌向咽后壁的脱垂，但舌头位置正常。 2级是会厌和舌根脱垂，只有会厌尖端可见。 3级是舌苔症，没有会厌部分可见。回顾了EBT脱垂的诊断方式和治疗方法。结果：在研究的14名儿童中，有7名（50％）为1级，4名（29％）为2级，三名（21％）为3级EBT脱垂。吞咽功能障碍（5岁，占14岁，38％）和胃食管反流疾病（13岁，占14岁，93％）也很普遍。结论：新分级系统已成功应用于描述14例EBT脱垂儿童的气道阻塞严重程度和部位。该人群发生吞咽功能障碍和胃食管反流疾病。尽管外科手术疗法有时是有效的，但气管切开术以外的其他方法缺乏持续的成功率和误吸风险可能导致一些人得出结论，认为持续气道正压或气管切开术是最安全的选择。

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