Laryngomalacia is the most common congenital laryngeal anomaly and the leading cause of inspiratory stridor in neonates and infants. The etiology is multifactorial, with the most widely accepted theory being neuromuscular immaturity of the laryngeal structures, particularly the supraglottis. This immaturity leads to dynamic collapse of supraglottic tissues—namely the epiglottis, aryepiglottic folds, and arytenoid cartilages—during inspiration due to inadequate neuromuscular tone and coordination. Anatomically, findings often include an omega-shaped epiglottis, short aryepiglottic folds, and redundant arytenoid mucosa, all contributing to airway obstruction during the inspiratory phase of respiration. Additionally, laryngomalacia is frequently associated with gastroesophageal reflux disease (GERD), which may exacerbate the condition by causing laryngeal inflammation and edema. In some cases, immaturity of the laryngeal cartilage also contributes to the increased compliance and collapsibility of the airway. While most cases are idiopathic and resolve spontaneously with growth and maturation, laryngomalacia may be more severe or persistent in infants with underlying neurologic impairment, hypotonia, or syndromic diagnoses. When severe, it can result in feeding difficulties, poor weight gain, or sleep-related breathing issues. Supraglottoplasty is a minimally invasive surgical procedure to relieve airway obstruction by trimming or repositioning floppy supraglottic tissues. In this video we have described the use of coblation want to release aryepiglottic folds and to reduced redundant arytenoid tissue to improve laryngomalacia collapse during inspiration.
School: Children's Airway & Swallowing Centre
Rigid Bronchoscopy Assembly Guide for Airway Foreign Body
This is the rigid bronchoscopy assembly guide video for the removal of airway foreign body. Every piece is custom design so they only fit into one place. The light prism is placed just one slide, so it does not block the lumen from the Endoscope. This is required if the bronchoscope is been used with the glass window attached to it. Next is the flexible suction catheter adapter. This just snaps in the place. The adapter allows for small flexible suctions or other instruments to pass the bronchoscope. Endoscope adapter has a locking mechanism to lock it in place. Again. There are many size and shape combinations between bronchoscopes and endoscopes, It is suggested to take some time to test out instrumentation so that you prepare before an emergency occurs. It’s now time to select your ideal optical force and tested through the bronchoscope. The correct choice depends on your foreign body. Sometimes this is unknown, so it’s perfectly fine to have them ready to go at the start of the case. It’s time to make sure that they all work correctly before the patient arrives the room, which is the most important part of the set up. Make sure the scope has good light for this age. Look through the Endoscope with your eye to make sure there are no obstruction to review, and the Endoscope is not broken. Next check the functionality of your optical forces to see if the tips come together. Well, these fragile instruments and tips can easily bend. If they are. They may not be able to grab your foreign body well. Please be sure to connect your telescope with the light cable. This whole assembly can then be passed on the Bronchoscope.
Pediatric Tracheostomy
Paediatric Tracheostomy
Position the child with chin extension appropriately
Drape the child as shown in the video
Mark the incision line
Use 15 number blade for skin incision
Remove the excessive subcutaneous fat tissue
Find the median raphe and strap muscles
Retract the strap muscles laterally
Identify the tracheal ring
Create the impression of tube for appropriate size incision
Place the stay sutures as shown in the video
incise the trachea with 11 number blade
Secure the maturation sutures
Insert the tracheostomy tube
Confirm the position and then inflate the cuff
Secure the ties and dressing at the end.