Upper Airway Obstruction In Children Research Articles

Acute Upper Airway Obstruction in Children

Acute Upper Airway Obstruction in Children

Upper airway obstruction in children: An update

Upper airway obstruction in children: An update

Does drop in T and A's pose new issue of adenotonsillar hypertrophy?

The A he dramatic trend over the last two decades of treating otitis media and pharyngotonsillitis conservatively—with antimicrobial agents and tympanostomy tubes rather than surgical removal of the tonsils and adenoids—may be causing an increasing incidence of airway obstruction from adenotonsillar hypertrophy. At the recent meeting of the southern section of the Triological Society in Atlanta, Kenneth M. Grundfast, MD, chairman of the Department of Otorhinolaryngology at Children's Hospital National Medical Center, Washington, DC, and Donald J. Wittich, Jr, MD, of the Head and Neck Surgery Service at Walter Reed Army Medical Center, Washington, DC, described 13 cases that they had seen in the last year of acute or chronic upper airway obstruction in children due to adenotonsillar hypertrophy. (In fact, Grundfast told<i>JAMA</i>MEDICAL NEWS, since preparing the report, he has seen two additional cases.) The 13 children ranged in age from 15 months to 10 years. Nine had

Sleep Disorders Associated with Upper Airway Obstruction in Children

Improved case identification of children with upper airway obstruction during sleep should result if physicians are aware of such signs and symptoms as excessive daytime sleepiness, loud snoring, restless sleep, recurrent nocturnal enuresis, systemic and pulmonary hypertension, undergrowth or obesity, and cor pulmonale. Furthermore, partial airway obstruction during wakefulness may be a risk factor for the development of sleep apneas or hypopneas. In suspected cases, polysomnography is a useful method for confirming and quantitating the type (central, obstructive, or mixed) and extent of ventilatory disturbance during sleep and its functional significance (such as arterial oxyhemoglobin desaturation or cardiac arrhythmia). Other methods may be employed to yield similar data. There seem to be at least two groups of children reported in the literature, those in whom there is a specific surgically correctable lesion (such as adenotonsillar hypertrophy) versus those who eventually need tracheotomy because of collapse of upper airway musculature during sleep. In the latter group of children, it is necessary to hypothesize an additional defect in the CNS regulation of respiration during sleep. Further research is necessary to define the boundary between normal and abnormal breathing during sleep, and to understand more thoroughly the effects of intermittent hypoventilation on daytime functioning.

Upper airway obstruction in children.

Upper airway obstruction in children.

Acute upper airway obstruction in children

Acute upper airway obstruction in children

Evaluation of tonsils and adenoids in Sleep Apnea syndrome.

Peripheral Sleep Apnea syndrome has been associated with enlarged tonsils and adenoids as well as other abnormalities which may cause upper airway obstruction in children. A multidisciplinary approach is used at the Step Disorder Center of Cincinnati General Hospital to evaluate the role of tonsils and adenoids in sleep apnea. Polysomnographic techniques combined with cine sleep studies of the upper airway document the degree, site and type of obstruction. This presentation highlights the entity of obstructive sleep apnea and provides a rational clinical approach in the management of these patients.

Comparison of Nasotracheal Intubation and Tracheostomy in the Management of Upper Airway Obstruction in Children

Comparison of Nasotracheal Intubation and Tracheostomy in the Management of Upper Airway Obstruction in Children

Medical Management, Nasotracheal Intubation, and Tracheotomy in the Treatment of Upper Airway Obstruction in Children

Medical Management, Nasotracheal Intubation, and Tracheotomy in the Treatment of Upper Airway Obstruction in Children

Obstructions of the upper airway in children as reflected on the chest radiograph.

Alterations in the appearance of the heart and lungs that should lead one to suspect the possibility of upper airway obstruction in children are: distension of the hypopharynx, underaeration of the lungs, cardiac enlargement, cardiac enlargement with passive congestion, and pulmonary edema without cardiac enlargement.

AIRWAY OBSTRUCTION IN INFECTIOUS MONONUCLEOSIS.

Upper airway obstruction in children often presents interesting and unusual problems. Severe obstruction resulting from profound hyperplasia of Waldeyer's ring is unusual whereas mild obstruction is common. The case to be presented is one of profound obstruction, secondary to infectious mononucleosis, necessitating an emergency tonsillectomy and adenoidectomy. A 20-year review of the available literature uncovered a number of cases of upper airway obstruction of various etiologies.7,8Johnson1in 1944 reported the first two proven cases of infectious mononucleosis in the Negro. One of these had an anginose obstruction. The Negro child was having intermittent respiratory distress, and tracheotomy was thought necessary on several occasions. The first case of surgical intervention, a tracheotomy was reported by Jones and Jones2in 1949. Librach3in 1951 presented one case of obstruction due to infectious mononucleosis and reviewed six others, all of which were treated with tracheotomy. In 1953 a