喉頭軟化症の診断と治療

抄録

Laryngomalacia is the most common cause of inspiratory stridor in infancy. Obstruction and stenosis of the larynx during inspiration cause symptoms such as inspiratory stridor and obstructive apnea. Diagnosis is made by bronchoscopy, and depending on the lesion it is classified into 3 types. Type 1 is caused by prolapse of mucosa overlying the arytenoid cartilages, Type 2 is caused by foreshortened aryepiglottic folds, and Type 3 is caused by posterior displacement of the epiglottis. In most cases, no special treatment is necessary and the disease will resolve naturally in about a year. In some severe cases, conservative management may become difficult due to symptoms such as feeding difficulty, poor weight gain, breathing difficulty and obstructive apnea, and aggressive treatment may become necessary. Examples of aggressive therapy are laryngoplasty for Types 1 and 2 laryngomalacia, and epiglottopexy for Type 3 laryngomalacia. In this paper, diagnosis and treatment of laryngomalacia will be discussed.