Congenital Laryngeal Atresia Research Articles

Fetoscopic Balloon Dilation and Cricotracheal Resection for Laryngeal Atresia in CHAOS.

View Supplementary Video 1 Laryngoscope, 131:660–662, 2021

Clinical Outcomes of Nine Patients With Congenital Laryngeal Atresia

Clinical Outcomes of Nine Patients With Congenital Laryngeal Atresia

D 型食道閉鎖に合併した先天性喉頭閉鎖症の1 例

D 型食道閉鎖に合併した先天性喉頭閉鎖症の1 例

Utility of a Partial Autopsy: A Case Report of Congenital Laryngeal Atresia

Laryngeal atresia is a rare congenital anomaly that is fatal if not quickly diagnosed at birth. Here we report a case of unexpected congenital laryngeal atresia and esophageal atresia in a preterm male infant, in whom prenatal ultrasonic findings were limited to polyhydramnios and duodenal atresia. Attempts at intubation and emergent tracheotomy were unsuccessful. A diagnosis of congenital laryngeal atresia with esophageal atresia was made during a restricted autopsy (limited to the neck). In an era of declining autopsy rates nationwide, this case emphasizes the value of limited autopsy examinations, focused on the region of interest.

Respiratory distress of the newborn: Congenital laryngeal atresia

Congenital laryngeal atresia is a rare cause of respiratory distress of the newborn. The defect may be isolated or occur in association with other congenital abnormalities, notably the presence of a tracheoesophageal fistula, esophageal atresia, encephalocele, or Congenital High Airway Obstructive Syndrome (CHAOS). We present the case of a newborn with no identified intrapartum abnormalities with respiratory distress at birth secondary to near-complete laryngeal atresia. Management included tracheostomy, repeated endoscopic incisions, and serial balloon dilatations employing the topical use of Mitomycin C. Seven year follow-up was significant for mobilization of the true vocal cords bilaterally, as well as successful decannulation.

An unsuspected congenital laryngeal atresia with an associated tracheoesophageal fistula

An unsuspected congenital laryngeal atresia with an associated tracheoesophageal fistula

P17.05: Congenital laryngeal atresia: prenatal diagnosis and management, about a retrospective French study of 7 cases

P17.05: Congenital laryngeal atresia: prenatal diagnosis and management, about a retrospective French study of 7 cases

Slide thyrocricotracheoplasty: a novel surgical technique for congenital laryngeal atresia

The aim of this study was to introduce a new surgical technique for the correction of congenital laryngeal atresia. A female baby had laryngeal atresia at birth and received emergency tracheostomy at another hospital. The baby visited our hospital at 7 months of age for corrective surgery of airway obstruction. We used a new surgical technique for reconstruction of her airway, the slide thyrocricotracheoplasty, which was a modification of slide tracheoplasty and anterior cricoid split. The extubation was successful at the postoperative fifth day, and the baby was discharged on the 33rd day after operation. The serial follow-up bronchoscopy on the fourth and 18th postoperative months revealed good healing and normal growth of tissue at operation site without stenosis and granulation. Slide thyrocricotracheoplasty produced a desirable result and offered the same advantages as slide tracheoplasty. The authors believe that this technique offers an efficient surgical procedure for the single-staged correction of congenital laryngeal atresia.

Prenatal diagnosis and postnatal management of congenital laryngeal atresia in a preterm infant

Laryngeal atresia is a rare congenital cause of high airway obstruction that can lead to death if not correctly recognized and treated at birth. Postnatal management is difficult and the prognosis is often poor. We report a case of prenatal diagnosis of laryngeal atresia in a fetus that was delivered preterm at 29 weeks of gestation. Tracheotomy was performed as an ex utero intrapartum treatment (EXIT) to guarantee patent airway, and laryngotracheoplasty was performed at 22 months of corrected age. A favorable ventilatory and neurodevelopmental outcome was observed at 33 months of age.

P-256A A case of successful EXIT (ex utero intrapartum treatment) procedure for congenital laryngeal atresia(Fetus, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-256A A case of successful EXIT (ex utero intrapartum treatment) procedure for congenital laryngeal atresia(Fetus, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

Congenital laryngeal atresia associated with esophageal atresia and tracheoesophageal fistula: a case of long-term survival

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.

Clearance of Fluid From Airspaces of Newborns and Infants

After completing this article, readers should be able to: 1. Describe fetal lung fluid secretion, its application on lung development, and its reabsorption immediately after birth. 2. List the primary cellular mechanism responsible for lung fluid absorption. 3. Describe clinical conditions in newborns and infants associated with impaired sodium transport. 4. Describe how sodium transport can be influenced by fetal lung maturity. When the airspaces of the lungs are filled with fluid, normal gas exchange cannot take place, and there is marked respiratory distress and the need for intensive care. This occurs in only two situations: failure to clear fetal lung liquid at birth and leakage of fluid from the vasculature filling the alveoli (alveolar pulmonary edema). Fluid that is secreted into the fetal airspaces to enable normal lung development must be absorbed at the time of birth for a normal transition from fetal to postnatal life. Failure to do so can lead to two well-known clinical syndromes: transient tachypnea of the newborn (TTN) and when there is coexistent relative surfactant deficiency, neonatal respiratory distress syndrome (nRDS). Pulmonary edema can be caused postnatally by many disorders; those that occur frequently during the neonatal period are patent ductus arteriosus or structural congenital heart disease with marked left-to-right shunting. It is not only biologically reasonable to assume that clearance of such airspace fluid would be beneficial to the patient, but studies in adults suffering from pulmonary edema have shown that the lung’s ability to clear such fluid correlates with survival. In this article, we review how the epithelium of the lung uses the active transport of sodium (Na+), followed by chloride (Cl−) and water, from the apical to basolateral side of the alveolar lining cells to clear fluid and how the underlying mechanisms for active Na+ transport are influenced by the degree of …

Pulmonary function studies in a newborn with congenital laryngeal atresia

Congenital laryngeal atresia is a rare cause of upper airway obstruction that leads to death unless a surgical airway is immediately established. We were able resuscitate a baby boy with laryngeal atresia by the placement of an 18-gauge plastic intravenous cannula into the trachea, connected in turn to a 3-mL syringe without the plunger, and then to the connector to a 7.0-mm endotracheal tube. This arrangement allowed hand ventilation and sufficient gas exchange until a formal tracheotomy was established minutes later. The baby boy had deficient abdominal musculature (without cryptorchidism or obstructive uropathy), bilateral inguinal hernias, and idiopathic hypercalcemia (since spontaneously resolved), but no other major anomalies. His survival allowed measurements of pulmonary function in lungs distal to an obstructed upper airway, an arrangement that mimics experiments that examine the influence of lung fluid volume and pressure on developing lungs. The baby's lungs had a forced vital capacity (FVC) in the upper limits of normal (not grossly enlarged lungs seen in newborn animals undergoing ligation of the trachea in utero). Maximal expiratory flow at 25% of FVC from residual volume (MEF 25) was decreased, indicating airway obstruction involving smaller airways. Although direct laryngoscopy falled to find a opening in the larynx, some communication probably existed during development to allow some drainage of lung fluid. This opening, in the form of a persistent pharyngoglottic duct, prevented gross distention of the developing lung, but provided an insufficient airway at birth.

Management of a Newborn Infant with Congenital Laryngeal Atresia

Hoka, Sumio MD; Sato, Michiko MD; Yoshitake, Junichi MD; Kukita, Jeoji MD Author Information

Development of congenital laryngeal atresias and clefts.

Congenital supraglottic laryngeal obstruction still is being described as subglottic stenosis. There are three clearly defined types of congenital laryngeal atresia, which result from arrest at consecutive developmental stages. Type 1 consists of a supraglottic obstruction, absent vestibule, and stenotic infraglottis, and type 2 is a supraglottic obstruction that separates a shallow primitive vestibule above from a nonstenotic infraglottis. These two types usually are accompanied by other defects, many of them severe. In type 3, a perforated membrane partly obstructs the glottis. Arrest of the dorsal advance of the chondrifying cricoid before the ends meet to form the dorsal lamina results in a complete laryngeal cleft, and incomplete fusion of the ends may leave a notch and/or foramen within the lamina. Failure of the interarytenoid tissue to develop will produce a local cleft, and maldevelopment of the cricoid cartilage or infraglottic submucosa can result in true subglottic stenosis without supraglottic obstruction.

Congenital subglottic stenosis.

CONGENITAL laryngeal atresia was first described by Rossi in 1826. Since that time, increasing attention has been directed towards laryngeal anomalies as a major cause of asphyxia neonatorum. Reports in the German literature by Schneider, Hempel, and Kneizl of 26 cases of laryngeal atresia are referred to by Smith and Bain. 1 Holinger et al 2 reported 379 cases of congenital laryngeal anomalies, 305 of which were diagnosed as congenital laryngeal stridor or laryngomalacia. Of the remaining 74 cases, the largest group (34) was congenital subglottic stenosis. Other reports 3-6 support the fact that subglottic stenosis occurs more frequently than is realized. Subglottic stenosis as defined in this paper is a developmental defect of the conus elasticus and/or cricoid cartilage. Since 1950, we have had four cases of this congenital anomaly at the University of Minnesota and affiliated hospitals. Report of Cases Case1.—This white male infant was the firstborn