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Early-onset pharyngeal airway collapse in infants: a retrospective single-center study
Wei Qing1, Chen Xun1, Nong Guangmin1
1Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
Insights
Early-onset pharyngeal airway collapse (PAC) in infants is rare but treatable. While most infants improve with age, those with comorbidities face a poor prognosis, highlighting the need for early intervention.
Area of Science:
- Pediatrics
- Otolaryngology
- Respiratory Medicine
Background:
- Early-onset pharyngeal airway collapse (PAC) in infants, presenting within the first six months of life, is a rare condition often overlooked in clinical practice.
- This study addresses the limited attention given to early-onset PAC in infants.
Purpose of the Study:
- To investigate the clinical characteristics, endoscopic findings, and patient outcomes associated with early-onset PAC in infants.
- To understand the long-term prognosis of infants diagnosed with early-onset PAC.
Main Methods:
- A retrospective study was conducted.
- Included 26 infants diagnosed with PAC with onset within the first six months of life.
- Clinical data, endoscopic findings, and outcomes were analyzed.
Main Results:
- The majority of cases (20/26) presented in the neonatal period, with noisy breathing and suprasternal retraction being common symptoms.
- Retropalatal collapse was the most frequent endoscopic finding (24/26).
- Infants with comorbidities (cerebral impairment, craniofacial abnormalities) had a significantly higher incidence of poor prognosis (death, neurodevelopmental disorders) compared to those without (P<0.01).
Conclusions:
- Early-onset PAC in infants generally shows symptomatic improvement with age.
- However, infants with coexisting comorbidities face a significantly poorer prognosis, emphasizing the importance of managing these associated conditions.
Background:
Early-onset pharyngeal airway collapse (PAC) in infants, which presents with onset within 6-months old is relatively rare. This disease has not been given enough attention in clinic. The aim of this study was to explore the clinical features, endoscopic findings and outcomes of early-onset PAC in infants.
Methods:
The children of PAC with onset within 6-months old were included. A retrospective study was conducted.
Results:
(1) Total 26 cases were included. The age of onset was neonatal period in 20 cases, 1 to 3-months old in 5 cases, and 4 to 6-months old in 1 case. (2) The main clinical manifestations were noisy breathing (26/26), suprasternal retraction (18/26), snoring (14/26) and hypoxic episode (13/26). (3) Based on the endoscopic findings, collapse at the retropalatal level was most common (24/26). (4) Twelve cases underwent pharyngolaryngeal CT examination, which revealed abnormal findings in 7 cases. (5) Fifteen cases were accompanied with the other airway malformations. (6) In the group with comorbidities of cerebral impairment or craniofacial abnormalities, 1 case was lost to follow up, 4 cases died, and 10 cases survived, in which 9 cases had neurodevelopmental disorders. In the group without comorbidities, 2 cases were lost to follow up, 9 cases survived, in which 1 case had neurodevelopmental disorders. The incidence of poor prognosis including death and neurodevelopmental disorders was significantly higher in the group with comorbidities than that without comorbidities (P<0.01). (7) An symptomatic improvement of PAC was found in the majority of the survived cases (18/19) with age.
Conclusions:
Early-onset PAC in infants usually exhibits varying degrees of relief with age, whereas the cases with comorbidities had a poor prognosis.
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