Congenital Causes of Upper Airway Obstruction in Pediatric Patients: Updated Imaging Techniques and Review of Imaging Findings

Abstract

Upper airway obstruction is a common and potentially serious condition in the pediatric age-group. Neonates and young children are particularly susceptible because their immatureairwaysaresmallinsizeandmuchmorecompliant than those of adults. 1 Children with upper airway obstructionusuallypresentwithstridororapnea,buttheycouldalso manifest with chronic problems, such as recurrent lung infections or obstructive sleep apnea, that can lead to growth retardation, chronic respiratory failure, cor pulmonale, and even death.2 Common causes of upper airway obstruction in children include congenital abnormalities, infectious or inflammatory processes, neoplasms, foreign body aspiration, and even trauma. Congenital abnormalities involving the structures of the pharynx and larynx are not uncommon and can cause upper airway obstruction in children. Such abnormalities may present at birth or can manifest after an inciting event. Although the clinical symptoms and physical examination are important in establishing the diagnosis, it is not always easytoclinicallylocalizetheabnormality.Therefore,imaging evaluation is helpful in establishing the diagnosis, defining the anatomic localization, and assessing the extent of the abnormality. Radiographs and fluoroscopy have long been used in the evaluation of the upper airway in pediatric patients, but cross-sectional imaging studies can provide more detailed and accurate demonstration of upper airway abnormalities. 3 The overarching goals of this article are to discuss updated imaging techniques and review characteristic imaging appearance of congenital causes of upper airway obstruction in pediatric population.