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Pharyngeal wall collapse and multiple synchronous airway lesions
Anat Shatz1, Shmuel Goldberg, Elie Picard
1Pediatric Airways Clinic, Shaare Zedek Medical Center, Jerusalem 91031, Israel.
The Annals of Otology, Rhinology, and Laryngology
|July 1, 2004
Summary
Pharyngeal wall inspiratory collapse (PWIC) is a common cause of upper airway obstruction (UAO) in infants. Recognizing PWIC improves diagnosis and treatment of infant breathing difficulties.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Pediatric Sleep Medicine
Background:
- Pharyngeal wall inspiratory collapse (PWIC) is a dynamic upper airway obstruction during inspiration.
- Understanding PWIC's role in infant upper airway obstruction (UAO) is crucial for effective management.
Purpose of the Study:
- To determine the incidence of PWIC in infants with UAO.
- To evaluate PWIC's contribution to UAO symptoms.
- To establish indications for intervention in PWIC cases.
Main Methods:
- Retrospective review of endoscopic evaluations and clinical data from 108 infants with UAO.
- Diagnosis of PWIC through endoscopic assessment.
- Correlation analysis of PWIC severity with clinical presentation and treatment needs.
Main Results:
- PWIC was diagnosed in 46% of infants with UAO.
- Apnea was the most frequent presenting symptom (52%).
- PWIC frequently co-occurred with laryngomalacia (78%) and generalized hypotonia (80%).
- PWIC severity correlated with apnea and the need for bi-level positive airway pressure (BiPAP).
- Spontaneous recovery was observed within 36 months.
Conclusions:
- PWIC is highly prevalent in infants with UAO and significantly contributes to symptoms.
- A new classification for PWIC severity aids in assessing apnea and BiPAP requirements.
- Improved diagnosis of PWIC can enhance UAO treatment strategies in infants.