Abstract:

Background: Laryngomalacia is the commonest congenital abnormality of the larynx. It the most important cause of stridor in neonates and infants stridor in the main presenting symptoms. In majority of the patient seen especially in peripheral health centers clinical symptoms and signs are relied upon for the diagnosis of the condition. Flexible laryngoscopy is however the mainstay of diagnosis. Objective: The aim of this study is to compare clinical findings and endoscopic findings of laryngomalacia in department of Ear, Nose and Throat of Aminu Kano Teaching Hospital Northern Nigeria. Material and Methods: We undertook a prospective cross – sectional review of all patient with larynomalacia who presented at the department of ENT Aminu Kano Teaching Hospital between June 2012 to May 2014. Bio – data and clinical information were obtained and stridor graded. Then flexible fiber optic laryngoscopy was done on the entire patient and the stage of endoscopic grading documented. RESULT: A total of 35 children were seen during the study period and 26 met the inclusion criteria and were enrolled. There were 17 (65.4%) males and 9 (34.6%) females with a male female ratio of 2.1:1. There ages ranged from 1day to1year. The mean age at presentation was 5 ± 2.71 months. Twenty six (100%) of the children presented with different degrees of stridor. Based on, the clinical staging of stridor the degree of stridor found was 21(80.8%) had grade 1 to 2 stridor, and 5 (19.2%) had grade 3 none was found to have grade 4 stridor. Clinical assessment of the severity of the condition by the same investigators, 17 (65.4%) of the patients had mild laryngomalacia, 5 (19.2%) had moderate laryngomalacia and 4 (15.4%) had severe laryngomalacia. Objective endoscopic grading of findings in these patients showed 18 (69.2%) of the patients had grade 1 to 2, 3 (11.5%) had grade 3 and 5 (19.2%) had grade 4 to 5 laryngomalacia. Using the Spearman rho correlation coefficient test, we found a significant strong positive correlation between clinical assessment and endoscopic grading of laryngomalacia (r=0.860, P=0.000).Conclusion: clinical evaluation still has significant reliability in the diagnosis of laryngomalacia. But flexible laryngoscopy remains the mainstay of diagnosis and all patients with laryngomalacia should have flexible laryngoscopy.

Keywords: Laryngomalacia, Stridor, flexible laryngoscopy.

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