Objective:To analyze the clinical data of laryngeal airway diseases in infants and provide reference for the standardized diagnosis and treatment of the disease. Methods:From June 2022 to August 2023, analyze the clinical data of 4 cases of children with laryngeal airway diseases recently admitted to Department of Otolaryngology, Fuzhou Children's Hospital of Fujian Province, and summarize the experience and lessons of diagnosis and treatment by consulting relevant literature. Results:Three cases had symptoms such as laryngeal wheezing, dyspnea, backward growth and development, etc. After electronic laryngoscopy, the first case was diagnosed with laryngeal softening （severe, type Ⅱ）, and the angular incision was performed. While cases 2, 3 diagnosed with case 2 and 3 were diagnosed with laryngeal cyst and underwent laryngeal cyst resection. All three cases underwent low-temperature plasma surgery under visual laryngoscope, and the symptoms were relieved after operation. Case 4 was laryngeal wheezing and dyspnea after extubation under general anesthesia. The electronic laryngoscopy showeded early stage of globetic stenosis, and endoscopic pseudomembrane clamping was performed, and the postoperative symptoms were relieved. Conclusion:Infants and young children with laryngeal airway diseases should pay attention to the early symptoms and be diagnosed by electronic laryngoscopy as soon as possible. With good curative effect and few complications, low-temperature plasma surgery under visual laryngoscope is recommended. The formation of pseudomembrane under the gluteal caused by tracheal intubation causes rapid onset and rapid development. The pseudomembrane extraction by clamping is convenient and fast, with good curative effect.
Infant ; Child ; Humans ; Child, Preschool ; Respiratory Sounds/etiology* ; Larynx ; Laryngeal Diseases/surgery* ; Laryngoscopy ; Intubation, Intratracheal/adverse effects* ; Dyspnea/surgery* ; Cysts/surgery*

Congenital laryngomalacia is the most common disease causing laryngeal stridor in infants. The pathogenesis has not yet been clearly concluded. It may be related to abnormal development of laryngeal cartilage anatomical structure, neuromuscular dysfunction, gastroesophageal and laryngeal reflux disease, etc. The typical manifestations of the disease are inspiratory laryngeal stridor and feeding difficulties, which can be divided into mild, moderate and severe according to the severity of symptoms. The diagnosis is mainly based on clinical symptoms, signs and endoscopy, among which endoscopy is an important diagnostic basis. The treatment of laryngomalacia depends on the severity of symptoms. Mild and some moderate congenital laryngomalacia children can be relieved by conservative treatment, and severe and some moderate congenital laryngomalacia children should be treated by surgery. Supraglottic plasty is the main surgical method, which can effectively improve the symptoms of laryngeal stridor, dyspnea, feeding difficulties and growth retardation in most children, and the surgical effect is good.
Infant ; Child ; Humans ; Laryngomalacia/therapy* ; Respiratory Sounds/etiology* ; Larynx/surgery* ; Laryngeal Diseases/surgery* ; Endoscopy/adverse effects* ; Laryngismus

Humans ; Child ; Infant ; Respiratory Sounds/etiology* ; Asthma/complications* ; Risk Factors

OBJECTIVETo investigate the risk factors for recurrent wheezing in infants and young children suffering from dust mite allergy after their first wheezing.

METHODSA total of 1 236 infants and young children who experienced a first wheezing episode and were hospitalized between August 2014 and February 2015 were enrolled, among whom 387 were allergic to dust mites. These infants and young children were followed up to 1 year after discharge. A total of 67 infants and young children who experienced 3 or more recurrent wheezing episodes within 1 year were enrolled as the recurrent wheezing group, while 84 infants and young children who did not experience recurrent wheezing during follow-up were enrolled as the control group. Univariate analysis and multivariate logistic stepwise regression analysis were performed to investigate the risk factors for recurrent wheezing in these patients.

RESULTSThe univariate analysis showed that the age on admission, wheezing time before admission, Mycoplasma pneumoniae infection rate, and influenza virus infection rate were associated with recurrent wheezing. The multivariate logistic stepwise regression analysis showed that the older age on admission (OR=2.21, P=0.04) and Mycoplasma pneumoniae infection (OR=3.54, P=0.001) were independent risk factors for recurrent wheezing.

CONCLUSIONSInfants and young children who are allergic to dust mites, especially young children, have a significantly increased risk of recurrent wheezing if they are complicated by Mycoplasma pneumoniae infection during the first wheezing episode.

Animals ; Child, Preschool ; Female ; Humans ; Hypersensitivity ; complications ; Infant ; Logistic Models ; Male ; Pyroglyphidae ; immunology ; Recurrence ; Respiratory Sounds ; etiology ; Risk Factors

OBJECTIVETo investigate the percentage of T lymphocyte subsets and allergen screening results in infants and young children with Mycoplasma pneumoniae (MP) infection complicated by wheezing.

METHODSFlow cytometry was used to measure the percentage of peripheral blood T cell subsets in 354 infants and young children with MP infection complicated by wheezing (MP wheezing group), 336 infants and young children with MP infection but without wheezing (MP non-wheezing group), and 277 children with recurrent wheezing (recurrent wheezing group). Allergen screening was also performed for these children.

RESULTSBoth the MP wheezing group and recurrent wheezing group had significantly lower percentages of CD3and CD3CD8lymphocytes than the MP non-wheezing group (p<0.05). The MP groups with or without wheezing had a significantly higher percentage of CD3CD4lymphocytes than the recurrent wheezing group (p<0.05). Both the MP wheezing group and recurrent wheezing group had significantly higher percentages of CD3CD19and CD19CD23lymphocytes than the MP non-wheezing group (p<0.05), and the recurrent wheezing group had the highest percentages (p<0.05). The overall positive rate of food allergens was significantly higher than that of inhaled allergens (30.3% vs 14.7%; p<0.05). The positive rates of food and inhaled allergens in the recurrent wheezing group and MP wheezing group were significantly higher than in the MP non-wheezing group (p<0.05), and the recurrent wheezing group had the highest rates.

CONCLUSIONSImbalance of T lymphocyte subsets and allergic constitution play important roles in the pathogenesis of MP infection complicated by wheezing in infants and young children.

Allergens ; immunology ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia, Mycoplasma ; complications ; immunology ; Respiratory Sounds ; etiology ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo study the association between wheezing and Mycoplasma pneumoniae (MP) infection in infants and young children.

METHODSA total of 228 hospitalized infants and young children who were diagnosed with lower respiratory tract infection were enrolled and classified into initial wheezing group (n=65), recurrent wheezing group (n=83), and non-wheezing group (n=80). Fasting serum was collected on the day or the second day of admission. ELISA was used to measure MP-IgM, chemiluminescence was used to measure serum total immunoglobulin E (TIgE), and EUROLine was used to measure the common serum allergen specific immunoglobulin E (sIgE). The data on the manifestations of atopic constitution and the family history of allergic diseases were collected.

RESULTSThe initial wheezing group and the recurrent wheezing group showed significantly higher positive MP infection rate and serum TIgE level than the non-wheezing group (P<0.05). The recurrent wheezing group showed a significantly higher positive rate of sIgE than the initial wheezing group and the non-wheezing group (P<0.05), and in these patients, the manifestations of atopic constitution and the family history of allergic diseases were closed associated with the pathogenesis of wheezing.

CONCLUSIONSMP infection is closely associated with wheezing in infants and young children. MP is one of the most common pathogens for wheezing in infants and young children, and the allergen sIgE, atopic constitution, and a family history of allergic diseases are important risk factors for recurrent wheezing.

Child, Preschool ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male ; Pneumonia, Mycoplasma ; complications ; Recurrence ; Respiratory Sounds ; etiology

OBJECTIVETo study the possible immunological mechanism of wheezing attack in children with cytomegalovirus (CMV) infection.

METHODSA total of 25 under-5-year-old children with wheezing following CMV infection were enrolled. The expression of serum regulatory T cells (Treg)/T helper 17 (Th17) cytokines interleukin (IL)-10, IL-6, and IL-17, and peripheral blood lymphocyte subsets were determined. Twenty age-matched healthy children were selected as the control group.

RESULTSThe wheezing group had a significantly reduced serum IL-10 level, significantly increased IL-6 and IL-17 levels, significantly reduced levels of natural killer cells, and significantly increased levels of CD8+ T cells and CD19+ B cells, as compared with the control group.

CONCLUSIONSWheezing children with CMV infection have Treg/Th17 imbalance and cellular immune dysfunction, which may be an important immunological mechanism of the development of wheezing in children after CMV infection.

Child, Preschool ; Cytokines ; blood ; Cytomegalovirus Infections ; immunology ; Female ; Humans ; Infant ; Male ; Respiratory Sounds ; etiology ; immunology ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology

INTRODUCTIONThis study aimed to determine the prevalence of asthma-like symptoms among schoolchildren with low birth weight (LBW), and to compare the lung function of these children with that of children with normal birth weight.

METHODSThis was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary schools in Kota Bharu, Kelantan, Malaysia. The children were divided into two groups: those with LBW (< 2,500 g) and those with normal birth weight (≥ 2,500 g). Parents of the enrolled children were asked to complete a translated version of the International Study of Asthma and Allergies in Childhood questionnaire. Lung function tests, done using a MicroLoop Spirometer, were performed for the children in both groups by a single investigator who was blinded to the children's birth weight.

RESULTSThe prevalence of 'ever wheezed' among the children with LBW was 12.9%. This value was significantly higher than that of the children with normal birth weight (7.8%). Forced vital capacity (FVC), forced expiratory volume in one second, and forced expiratory flow when 50% and 75% of the FVC had been exhaled were significantly lower among the children with LBW as compared to the children with normal birth weight.

CONCLUSIONLBW is associated with an increased prevalence of asthma-like symptoms and impaired lung function indices later in life. Children born with LBW may need additional follow-up so that future respiratory problems can be detected early.

Asthma ; epidemiology ; etiology ; Child ; Cross-Sectional Studies ; Databases, Factual ; Female ; Humans ; Infant, Low Birth Weight ; Malaysia ; epidemiology ; Male ; Prevalence ; Respiratory Function Tests ; Respiratory Sounds ; Schools ; Spirometry ; Surveys and Questionnaires

Wheezing is one of the most common clinical manifestations of childhood respiratory diseases, mainly associated with virus infection. Recent years, bacteria colonization and its infection are reported to involve in childhood wheezing, especially in infantile wheezing. However, the bacteria flora in the airway is only a phenomenon or a reason to induce some childhood wheezing, and its roles, as well as the mechanism in the development of wheezing remain unknown. This article summarizes the research progress in the relationship between childhood wheezing and bacteria and in the possible mechanisms of childhood wheezing caused by bacteria.
Anti-Bacterial Agents ; adverse effects ; Bacterial Infections ; complications ; Humans ; Respiratory Sounds ; etiology ; Respiratory Tract Infections ; complications

Bronchoscopy ; Female ; Fiber Optic Technology ; Humans ; Infant, Newborn ; Male ; Respiratory Sounds ; diagnosis ; etiology