Patterns of airway obstruction of non-acquired origin in children with and without major congenital anomalies.

Gonçalves Dias, Rodrigo; Giger, Roland; Latzin, Philipp; Riva, Thomas; Casaulta, Carmen; Ulmer, Francis; Jaquet, Yves; Nisa, Lluís (2021). Patterns of airway obstruction of non-acquired origin in children with and without major congenital anomalies. (In Press). European journal of pediatrics Springer-Verlag 10.1007/s00431-021-04198-6

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Major congenital anomalies are known to play a role in the management and prognosis of airway obstruction. Most studies assess acquired forms of airway obstruction. Data on congenital or otherwise non-acquired forms of airway obstruction is sparse. In this retrospective, single-institution cohort study, we sought to evaluate and compare the patterns of airway obstruction in children with and without major congenital anomalies, and to assess the impact of management and outcome, irrespective of aetiology. Fifty-five patients were included, 23 with and 32 without underlying major congenital anomalies. Multilevel airway obstruction (usually affecting the nasopharynx, oropharynx, and the trachea) was more common in children with congenital anomalies (91% vs. 41%, p < .001). Consequently, these children required more frequent and earlier surgical management, especially tracheostomy and adenotonsillar surgery.Conclusions: Major congenital anomalies are associated with multilevel airway obstruction and poor functional prognosis. A simple clinical definition considering impact of major congenital anomalies on development and growth may help guide management plans following endoscopic evaluation of the entire airway and flanked by multidisciplinary discussions. What is Known: • Children with major comorbidities display increased disease severity and more prevalent multilevel airway obstruction • Previous studies include both children with acquired and non-acquired forms of airway obstruction; therefore, the actual impact major comorbidities in children with non-acquired causes of airway obstruction remain unclear. What is New: • A total of 42% children in this study population had major comorbidities with and impact on growth and/or psychomotor development, with a higher prevalence of multilevel airway obstruction and worse rates of functional improvement/recovery. • Children with major comorbidities require tracheostomy more often and earlier than those without major comorbidities, and remain tracheostomy-dependent for a longer time.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

UniBE Contributor:

Gonçalves Dias, Rodrigo; Giger, Roland; Latzin, Philipp; Riva, Thomas; Casaulta, Carmen; Ulmer, Francis; Jaquet, Yves Fabrice and Nisa Hernández, Lluís

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-6199

Publisher:

Springer-Verlag

Language:

English

Submitter:

Romy Melanie Rodriguez Del Rio

Date Deposited:

16 Sep 2021 15:12

Last Modified:

16 Sep 2021 15:12

Publisher DOI:

10.1007/s00431-021-04198-6

PubMed ID:

34291330

Uncontrolled Keywords:

Airway endoscopy Airway obstruction Congenital disorders Outcomes

BORIS DOI:

10.48350/159019

URI:

https://boris.unibe.ch/id/eprint/159019

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