Changing Breathing Pattern in Laryngomalacia after Surgery

Objective Most of the studies on the surgical treatment of severe laryngomalacia have aimed to describe the efficacy of the treatment in terms of improvement of clinical symptoms or anatomical findings. The aim of this study is to analyze the changes in breathing patterns following aryepiglottoplasty for severe laryngomalacia. Method A series of retrospective cases at a tertiary referral children’s hospital. Between 2005 and 2010, 40 infants with severe laryngomalacia were studied before (T1) and after surgery (T2). Breathing patterns were studied using an ultrasonic flow‐meter measuring: tidal volume, respiratory rate, time to peak and mean expiratory flow/expiratory time ratio. Results The surgical procedure was well tolerated in all the infants and no perioperative and long‐term complications were present. In T1, the breathing pattern is characterized by low tidal volume and high flow/expiratory time ratio (tPTEF/Te) and mean expiratory/mean inspiratory flow ratio (MEF/MIF), suggesting a severe reduction in upper airways patency for all patients. After surgery (T2), all above mentioned variables significantly improved, reaching normal values for the age. Conclusion Pulmonary function test in this study showed the diagnostic value of testing respiratory functionality in severe laryngomalacia and comparing them to clinical and endoscopic data. Moreover, we also propose the use of this available test to verify the therapeutic effects and to monitor future respiratory development in these infants.