Cricoid Cartilage Hypertrophy as the Cause of Larynx Stenoses: Case Report and Updated Literature Review
- PDF / 3,480,797 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 30 Downloads / 211 Views
CLINICAL REPORT
Cricoid Cartilage Hypertrophy as the Cause of Larynx Stenoses: Case Report and Updated Literature Review Luis F. Tintinago1,2 • William Victoria1,2 • Maria A. Velez-Esquivia1,3 Juan Jose Arias2 • Estephania Candelo1,2,3
•
Received: 4 September 2020 / Accepted: 31 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Aerodigestive obstruction due to cricoid hypertrophy is a rare and potentially life-threatening condition. We present a two-year-old female patient who displayed repetitive respiratory infections, swallowing disorder, and malnutrition without any eye signs or symptoms of airway alterations. We described a patient with aerodigestive obstruction generating a marked narrowing of the trachea immediately below the larynx due to severe thickening of the cricoid cartilage. She was successfully treated with surgery, and the clinical and radiological features of this condition are presented here with a review of the literature. Keywords Cricoid cartilage Hypertrophy Laryngotracheal stenosis Esophageal stenosis
Introduction Tracheal obstruction in an early stage of the neonatal period is rare compared with laryngeal obstruction, and in the majority of cases, it is due to external causes. The cricoid cartilage region is the narrowest area in the human infant’s airway [1]. Cricoid cartilage chondrocytes progress through stages of differentiation, beginning with
mesodermal precursors that evolve into chondrocytes by approximately eight weeks gestation [1]. This is followed by slowing of the proliferative phase between 1 and 4 years of age. Chondrocytes then enter a phase histologically similar to the hypertrophic phase. However, it is biochemically different from chondrocytes destined for endochondral ossification [2]. To illustrate this, chondrocytes in the hypertrophic phase produce type X collagen [2]. When the infant reaches 1 year of age, cricoid cartilage is composed of collagen II, collagen X and matrilin-1. When the child grows up, they will lose collagen X, and matrilin-1 will gradually increase [2]. In previous clinical studies, cricopharyngeal muscle defects were demonstrated in 18% of unselected barium esophagram studies [3]. For this reason, this etiology must be considered in the differential diagnoses and a possible cause of tracheal obstruction and dysphagia in the early developmental stage. We describe a patient with aerodigestive obstruction (ADO) generating a marked narrowing of the trachea immediately below the larynx due to severe thickening of the cricoid cartilage. This case could elucidate the diagnoses and differential diagnoses in future cases.
Case Report & Estephania Candelo [email protected] 1
Head and Neck and Airway Surgery, Fundacio´n Valle del Lili, Avenida Simo´n Bolı´var - Cra. 98 # 18-49, Cali, Colombia
2
School of Health Science, Universidad ICESI, Cali, Colombia
3
Clinical Research Center, Fundacio´n Valle del Lili, Cali, Colombia
A two-year-old female presented with a history of repetitive respiratory infections since 3 mon
Data Loading...
