Abstract
Congenital laryngeal atresia (LA) is a life-threatening anomaly in which appropriate
perinatal management is essential for survival. The authors report a neonate with
LA associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF) who
was successfully resuscitated by emergent tracheostomy. Before birth, the patient
had a diagnosis of EA based on the findings of polyhydramnios and absent stomach bubble.
Immediately after birth, severe respiratory distress, cyanosis, and sternal retraction
were evident. Because either endotracheal or esophageal intubation was unsuccessful,
an emergent tracheostomy was performed. A direct laryngoscope revealed a subglottic
atresia with normal appearance of the vocal cords. Repair of EA with TEF was performed
on the third day of life, and the postoperative course was uneventful. In 2 years
follow-up, the patient has no mental retardation nor central nervous impairment. Because
of the presence of TEF, the antenatal ultrasonogram did not demonstrate the characteristic
findings of the congenital high airway obstruction syndrome. This case represents
one of the very few reported cases of successful resuscitation of a neonate with an
unanticipated LA in which emergent airway management is required immediately after
birth.
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References
- Successful ex utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS) owing to laryngeal atresia.J Pediatr Surg. 1998; 33: 1563-1565
- Successful EXIT (ex utero intrapartum treatment) procedure in a fetus diagnosed prenatally with congenital high-airway obstruction syndrome due to laryngeal atresia.Eur J Pediatr Surg. 2000; 10: 328-333
- Congenital high airway obstruction syndrome: natural history and management.J Pediatr Surg. 2003; 38: 940-945
- Congenital high airway obstruction syndrome successfully managed with ex-utero intrapartum treatment.Ultrasound Obstet Gynecol. 2003; 22: 437-439
- A case of laryngeal atresia (congenital high airway obstruction syndrome) with chromosome 5p deletion syndrome rescued by ex utero intrapartum treatment.J Pediatr Surg. 2004; 39: 25-28
- Subglottic laryngeal atresia associated with tracheoesophageal fistula. Long-term survival.Clin Pediatr. 1985; 24: 523-525
- Laryngeal atresia in the newborn: surgical implications.Am J Perinatol. 1996; 13: 409-411
- Perinatal management of unanticipated congenital laryngeal atresia.Arch Otolaryngol Head Neck Surg. 1998; 124: 1368-1371
- Long-term survival in a patient with congenital laryngeal atresia and multiple malformations.Pediatr Surg Int. 1998; 13: 521-523
- Congenital anomalies of the larynx.Ann Otol. 1954; 63: 581-606
- Pulmonary function studies in a newborn with congenital laryngeal atresia.J Pediatr Surg. 1991; 26: 210-212
- Congenital atresia of the larynx.Ann Otol Rhinol Laryngol. 1965; 74: 338-349
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© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
