Nelson Textbook of Pediatrics 22nd Edition | Laryngomalacia (most common, 45-75%), subglottic stenosis, vocal cord paralysis, laryngeal webs/atresia, subglottic hemangioma, saccular cysts, laryngeal cleft, tracheomalacia, vascular rings (double aortic arch, pulmonary artery sling), tracheal stenosis, foregut cysts. Diagnosis: flexible laryngoscopy, bronchoscopy, CT/MRI/angiography. Management: observation (most laryngomalacia), supraglottoplasty, propranolol for hemangioma, surgical repair of stenoses/vascular rings.
🌐 paeds.online — Pakistan's Pediatric Platform| Anomaly | Diagnosis | Treatment |
|---|---|---|
| Laryngomalacia | Awake flexible laryngoscopy (omega epiglottis, short aryepiglottic folds) | Observation (90%), supraglottoplasty if severe |
| Subglottic stenosis | Bronchoscopy (Myer-Cotton grading) | Mild: observe; severe: laryngotracheal reconstruction, cricotracheal resection |
| Vocal cord paralysis | Awake flexible laryngoscopy (immobile cord) | Unilateral: often resolves; bilateral: tracheostomy, later glottic widening |
| Subglottic hemangioma | Bronchoscopy, MRI | Propranolol (first-line), steroids, laser, tracheostomy |
| Tracheomalacia | Flexible bronchoscopy (dynamic collapse) | Observation, CPAP, aortopexy if severe |
| Vascular ring | Barium swallow, CT angiography, MRI | Surgical division of ring |