Etiology analysis of upper airway obstruction in 54 newborn infants / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the etiology of neonatal upper airway obstruction(UAO) in order to perform early diagnosis and treatment,and to improve the prognosis.Methods Retrospectively analysis of the clinical data of 54 cases of neonatal UAO in Shengjing Hospital of China Medical University from Jan.2005 to Dec.2011 was performed.All patients received CT three dimensional reconstruction reconstruction,30 patients received the direct laryngoscopy,5 cases received the video laryngoscope,8 cases received pathological examination.All the cases received the determination of serum total calcium and ionized calcium,6 cases received upper gastrointestinal imaging,8 cases received chromosome inspection and 20 cases received echocardiography.Results CT scanabnormal in 21 cases,among them 15 cases of congenital cyst,5 cases of tongue fall blocking airway,and 1 case of choanal atresia(bilateral) ;another 33 patients were normal.Direct laryngoscopy results:abnormal in 13 cases,among them 12 cases of congenital cyst,and 1 case of glossoptosis;another 17 cases were normal.Electronic laryngoscopy results:5 cases were diagnosed as congenital laryngomalacia.Pathological examination results:7 cases of cyst wall by squamous epithelium composition,and 1 case of cyst wall by columnar epithelium composition.Serum total calcium and ion calcium level results:all patients were in the normal range.Chromosome examination results were normal.Upper gastrointestinal imaging results:1 normal case,5 cases of mild gastroesophageal reflux.Echocardiography results:4 cases were normal,10 cases of patent foramen ovale,2 cases of patent ductus arteriosus,4 cases of congenital heart disease (2 cases of atrial septum defect,1 case of ventricular septal defect,and 1 case of interatrial septum merger ventricular septal defect).Conclusions In the etiology of neonatal UAO,there is a lot of organic diseases except for congenital laryngomalacia.For the UAO induced by laryngeal stridor or undefinitely cause,CT scan should be taken as soon as possible.