Document Detail

Microaspiration in infants with laryngomalacia.
MedLine Citation:
PMID:  15475788     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES/HYPOTHESIS: Laryngomalacia is the most common congenital laryngeal anomaly and the most frequent cause of stridor in infants. Infants with laryngomalacia may have associated respiratory symptoms other than stridor. In this study, we evaluated whether infants with laryngomalacia have episodes of microaspiration by calculating the amount of lipids present in the alveolar macrophages. STUDY DESIGN: We reviewed bronchoalveolar lavage (BAL) findings obtained in 14 infants with laryngomalacia and in 11 control children. METHODS: BAL was performed during flexible fiberoptic bronchoscopy (FFB) to diagnose persistent stridor. The presence of microaspiration was determined by evaluating the amount of lipid per single macrophage, assigning each cell a score from 0 to 4 according to the amount of lipid in the cytoplasm. RESULTS: The lipid-laden macrophage index was similar in patients and controls (31.5, range 12-177 vs. 45, range 35-106). In 5 of the 14 (36%) patients the index exceeded 100, and more than 25% of the cells were graded 3 and 4, indicating the presence of microaspiration. The lipid-laden macrophage index correlated significantly with the number and percentage of BAL neutrophils (Pearson correlation test, r = 0.83, P < .001 and r = 0.925, P < .001) as a marker of lung inflammation. CONCLUSIONS: Infants with laryngomalacia may have episodes of microaspiration. BAL performed during FFB to evaluate stridor may add helpful therapeutic information without increasing the risks of the procedure.
Fabio Midulla; Roberto Guidi; Giancarlo Tancredi; Serena Quattrucci; Felix Ratjen; Sergio Bottero; Katia Vestiti; Paola Francalanci; Renato Cutrera
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  114     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-11     Completed Date:  2004-10-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1592-6     Citation Subset:  IM    
Servizio Speciale Fibrosi Cistica, Istituto di Clinica Pediatrica, Università di Roma La Sapienza, Italy.
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MeSH Terms
Bronchoalveolar Lavage Fluid
Laryngeal Diseases / complications,  congenital*,  diagnosis
Larynx / abnormalities*
Lipids / analysis
Macrophages, Alveolar / chemistry
Pneumonia, Aspiration / diagnosis,  etiology*
Reference Values
Respiratory Sounds / etiology*
Statistics as Topic
Reg. No./Substance:

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