Clinical analysis of neonatal upper airway abnormalities / 中国新生儿科杂志

ABSTRACT

Objective To study early diagnostic methods,treatment and prognosis of neonatal upper airway abnormalities.Method From Jan.2013 to Dec.2016,clinical data of neonates with upper airway abnormalities in neonatal department of our hospital was reviewed,including diagnostic methods,clinical manifestations,examination results,treat-ment and prognosis.Result Fifty-five cases of neonatal upper airway abnormalities were collected,including 34 males and 21 females,51 term infants and 4 premature infants.The most common diagnosis was congenital laryngomalacia (31 cases,14 of them had other upper airway abnormalities),followed by congenital cyst,vocal cord paralysis,laryngeal granuloma,Pierre Robin syndrome,etc.Most cases had presenting symptoms immediately or within days after birth,including dyspnea,cyanosis,laryngeal stridor,feeding difficulties,hoarseness and weak cry.Pneumonia occurred in 49 cases and respiratory failure in 16 cases.Thirty one cases received CT or MRI,abnormalities were found in 17 cases (54.8％).Thirty four cases received fiberoptic bronchoscopy,abnormalities were found in 33 cases (97.0％).The duration of hospital stay were 14 (7 ～20) days.Forty six cases were cured (20 cases received surgical treatment,26 cases conservative treatment),7 cases died (1 case died of chaotic atrial tachycardia and heart failure at 69-day after birth,and 6 cases died after discontinue of treatment),2 cases were lost on follow-up after discharge.Conclusion Newborn infants with upper airway abnormalities develop symptoms early,and some severe cases have respiratory failure.Imaging and fiberoptic bronchoscopy are helpful for diagnosis.Early surgical treatment can relieve airway obstruction and improve prognosis for congenital cyst,laryngeal granuloma,nasopharyngeal tumor and other space occupying lesions,and also severe upper airway obstruction caused by severe laryngomalacia,vocal cord paralysis,choanal atresia.