OBJECTIVES/HYPOTHESIS: @entity12203 is an @entity66 in which laryngeal tone is weak, resulting in dynamic prolapse of tissue into the larynx. Sensorimotor integrative function of the brainstem and peripheral reflexes are responsible for laryngeal tone and airway patency. The goal of this study was to elucidate the etiology of decreased laryngeal tone through evaluating the sensorimotor integrative function of the larynx. The secondary goal was to evaluate factors and medical comorbidities that contribute to the wide spectrum of symptoms and outcomes. STUDY DESIGN: Prospective and retrospective collection of evaluative data on @entity1 with @entity12203 at two tertiary care pediatric referral centers. METHODS: Two hundred one @entity1 with @entity12203 were divided into three groups on the basis of disease severity (mild, moderate, severe). @entity1 were followed prospectively every 8 to 12 weeks until symptom resolution or loss to follow-up. Sensorimotor integrative function of the larynx was evaluated in 134 @entity1 by laryngopharyngeal sensory testing (LPST) of the laryngeal adductor reflex (LAR) by delivering a duration- (50 ms) and intensity- (2.5-10 mm Hg) controlled air pulse to the aryepiglottic fold to induce the LAR. Medical records were retrospectively reviewed for medical comorbidities. RESULTS: The initial LPST was higher (P < .001) in @entity1 with moderate (6.8 mm Hg) and severe disease (7.4 mm Hg) compared with those with mild disease (4.1 mm Hg). At 1, 3, and 6 months, @entity1 with moderate and severe disease continued to have a higher LPST compared with those with mild disease. At 9 months, the LPST decreased in all subjects (3.1-3.5 mm Hg, P = .14), which also correlated with symptom resolution. Neurologic, genetic, and @entity299 were more common in @entity1 with severe disease (P < .001). @entity354 ( @entity354 ) and feeding problems more common in those with moderate and severe disease (P < .001). Apgar scores were lower in those with severe disease (P < .001). Most symptoms resolved within 12 months of presentation. Those with @entity354 benefited from treatment. Supraglottoplasty resulted in few complications. Multiple comorbidities (>3) influenced the need for tracheotomy. CONCLUSIONS: Laryngeal tone and sensorimotor integrative function of the larynx is altered. The degree of alteration correlated with disease severity, indicating that factors that alter the peripheral and central reflexes of the LAR have a role in the etiology of signs and symptoms of @entity12203 . @entity354 , @entity16 , and low Apgar scores influenced disease severity and clinical course, explaining the spectrum of disease symptoms and outcomes. Sensorimotor integrative function improved as symptoms resolved.

Abnormal sensorimotor integrative function of the larynx in XXXX : a new theory of etiology.

@entity1 :: ('9606', 'Species') :: ['Patients', 'infants'] @entity66 :: ('MESH:D004194', 'Disease') :: ['enigmatic disease'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurologic disease'] @entity12203 :: ('MESH:D055092', 'Disease') :: ['laryngomalacia', 'Laryngomalacia', 'congenital laryngomalacia'] @entity354 :: ('MESH:D005764', 'Disease') :: ['Gastroesophageal reflux disease', 'GERD'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac diseases']
@entity12203 :: (MESH:D055092,Disease) :: ['congenital laryngomalacia']
