Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laryngomalacia is the most common cause of stridor in infants. In severe cases, it results in obstructive sleep apnea, cor pulmonale, gastroesophageal reflux, failure to thrive, and pectus excavatum. Our experience with 24 children who underwent laser excision of redundant supraglottic tissue from May 1987 to July 1991 is reviewed. The technique emphasizes preoperative planning with flexible fiberoptic laryngoscopy, apneic anesthetic for the procedure, conservative resection of tissue and the need for complete airway evaluation. In our series, 71% of patients experienced complete resolution of symptoms. Nine of 10 postoperative sleep studies indicated improvement. In 4 patients, collapse developed later in other areas of the supraglottis, resulting in recurrence of stridor several months after the initial procedure, and requiring revision laryngoplasty. In several patients with other significant sites of upper airway obstruction (e.g., tonsils and adenoids, and a tongue base cyst), laryngomalacia became more significant following alleviation of the primary source of airway obstruction. Twelve patients (50%) required additional airway procedures either before or following initial laryngoplasty. Patient selection, sleep study data, and complications are reviewed.
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PMID:Laser laryngoplasty for laryngomalacia. 812 77

Exercise-inducible laryngeal obstruction (EILO) has been recognized as a not rare respiratory problem in youth practicing sports. The aim of the study was to test the mechanosensitivity of the larynx, and to identify the factors affecting it in a group of youth with proven EILO. Laryngeal sensory testing was performed in 54 adolescents and young adults with EILO. Laryngeal mucosal alterations were assessed according to the Reflux Finding Score (RFS). The data concerning diseases possibly affecting the upper airway, findings of previously performed flexible videolaryngoscopy during exercise, and RFS score were compared between the participants with laryngeal hyposensitivity and those with normal sensitivity. The participants with isolated vocal folds' adduction during an EILO attack were compared with those who demonstrated supraglottis collapse. Testing revealed an increased threshold for mechanical stimuli in 81.5% of participants. Among participants with hyposensitivity, there were significantly more participants with dysphagia during EILO attacks than among the participants with normal laryngeal sensitivity. The hyposensitivity group had a significantly higher RFS score compared with the other group. Isolated vocal folds' approximation was only observed in 11.9% of participants. These participants were younger and had asthma more frequently compared with the others. Only 16.9% of participants with EILO did not state symptoms related to gastroesophageal reflux. The decreased mechanosensitivity was detected in the majority of participants, suggesting that laryngopharyngeal reflux can be an important etiological factor. The problem of breathing difficulties during sport activities in youth can also be associated with the disproportionate growth of the respiratory tract.
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PMID:Laryngeal sensitivity testing in youth with exercise-inducible laryngeal obstruction. 2822 37