International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations

John Carter; Reza Rahbar; Matthew Brigger; Kenny Chan; Alan Cheng; Sam J Daniel; Alessandro De Alarcon; Noel Garabedian; Catherine Hart; Christopher Hartnick; Ian Jacobs; Bryan Liming; Richard Nicollas; Seth Pransky; Gresham Richter; John Russell; Michael J Rutter; Anne Schilder; Richard J H Smith; Julie Strychowsky; Robert Ward; Karen Watters; Michelle Wyatt; George Zalzal; Karen Zur; Dana Thompson

doi:10.1016/j.ijporl.2016.04.007

International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations

Int J Pediatr Otorhinolaryngol. 2016 Jul:86:256-61. doi: 10.1016/j.ijporl.2016.04.007. Epub 2016 Apr 7.

Authors

John Carter¹, Reza Rahbar², Matthew Brigger³, Kenny Chan⁴, Alan Cheng⁵, Sam J Daniel⁶, Alessandro De Alarcon⁷, Noel Garabedian⁸, Catherine Hart⁷, Christopher Hartnick⁹, Ian Jacobs¹⁰, Bryan Liming¹¹, Richard Nicollas¹², Seth Pransky³, Gresham Richter¹³, John Russell¹⁴, Michael J Rutter⁷, Anne Schilder¹⁵, Richard J H Smith¹¹, Julie Strychowsky¹⁶, Robert Ward¹⁷, Karen Watters², Michelle Wyatt¹⁸, George Zalzal¹⁹, Karen Zur¹⁰, Dana Thompson²⁰

Affiliations

¹ Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. Electronic address: jmcarter@luriechildrens.org.
² Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.
³ Rady Children's Hospital, San Diego, CA, USA.
⁴ Children's Hospital Colorado, Aurora, CO, USA.
⁵ Department of Pediatric Otolaryngology, The Sydney Children's Hospital Network-Westmead Campus, The University of Sydney, Sydney, NSW, Australia.
⁶ Department of Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
⁷ Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
⁸ Pediatric ENT Department, Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes, Paris, France.
⁹ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
¹⁰ Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹¹ Department of Otolaryngology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
¹² Department of Pediatric Otolaryngology, La Timone Children's Hospital, Aix-Marseille Université, Marseille, France.
¹³ University of Arkansas for Medical Sciences, Little Rock, AR, USA.
¹⁴ Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
¹⁵ evidENT, UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, UK.
¹⁶ Department of Otolaryngology-Head and Neck Surgery, Children's Hospital at London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
¹⁷ Department of Otolaryngology-Head and Neck Surgery, NYU Langone Medical Center, New York, NY, USA.
¹⁸ Great Ormond Street Hospital for Children, London, UK.
¹⁹ Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
²⁰ Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

PMID: 27107728
DOI: 10.1016/j.ijporl.2016.04.007

Abstract

Objective: To provide recommendations for the comprehensive management of young infants who present with signs or symptoms concerning for laryngomalacia.

Methods: Expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG).

Results: Consensus recommendations include initial care and triage recommendations for health care providers who commonly evaluate young infants with noisy breathing. The consensus statement also provides comprehensive care recommendations for otolaryngologists who manage young infants with laryngomalacia including: evaluation and treatment considerations for commonly debated issues in laryngomalacia, initial work-up of infants presenting with inspiratory stridor, treatment recommendations based on disease severity, management of the infant with feeding difficulties, post-surgical treatment management recommendations, and suggestions for acid suppression therapy.

Conclusion: Laryngomalacia care consensus recommendations are aimed at improving patient-centered care in infants with laryngomalacia.

Keywords: Infant; Laryngomalacia; Pediatric; Stridor.

Publication types

Practice Guideline
Review

MeSH terms

Algorithms*
Consensus*
Disease Management*
Female
Humans
Infant
Infant, Newborn
Laryngomalacia / complications
Laryngomalacia / diagnosis
Laryngomalacia / surgery*
Male
Patient-Centered Care
Practice Guidelines as Topic
Respiratory Sounds / etiology
Triage

Grants and funding

NIHR-RP-011-045/DH_/Department of Health/United Kingdom