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Submucosal nerve hypertrophy in congenital laryngomalacia

Authors

  • Patrick D. Munson MD,

    1. Department of Otolaryngology, Division of Pediatric Otolaryngology, and Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
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  • Ali G. Saad MD,

    1. Department of Pathology and Arkansas Children's Hospital, University of Arkansas Medical Sciences, Little Rock, Arkansas, U.S.A.
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  • Siraj M. El-Jamal MD,

    1. Department of Pathology and Arkansas Children's Hospital, University of Arkansas Medical Sciences, Little Rock, Arkansas, U.S.A.
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  • Yuemeng Dai MD, PhD,

    1. Department of Otolaryngology, Division of Pediatric Otolaryngology, and Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
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  • Charles M. Bower MD,

    1. Department of Otolaryngology, Division of Pediatric Otolaryngology, and Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
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  • Gresham T. Richter MD

    Corresponding author
    1. Department of Otolaryngology, Division of Pediatric Otolaryngology, and Arkansas Children's Hospital, Little Rock, Arkansas, U.S.A.
    • Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202
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  • Presented at the American Society of Pediatric Otolaryngology, Las Vegas, Nevada, U.S.A., May 2, 2010.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To determine the neuropathologic findings in tissue obtained from children with laryngomalacia at a tertiary-care pediatric hospital.

Study Design:

Retrospective review of consecutive cohort compared with a control group.

Methods:

We reviewed supra-arytenoid pathology specimens from 43 children with severe laryngomalacia and 13 age-matched pediatric autopsy controls. Histopathologic comparison was made of nerve hypertrophy (including nerve perimeter and surface area) among experimental and control pathologic specimens.

Results:

There exists a statistically significant increase in nerve perimeter (P = .001) and nerve surface area (P = .02) in supra-arytenoid specimens in patients with severe laryngomalacia compared with age-matched autopsy supra-arytenoid tissue.

Conclusions:

The pathologic finding of nerve hypertrophy in children with laryngomalacia provides new evidence to support neurologic dysfunction as the etiologic theory of laryngomalacia. Laryngoscope, 2011

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