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Airway management in children with craniofacial anomalies
J A Perkins1, K C Sie, H Milczuk
1Medical Corps, Otolaryngology-Head and Neck Surgery Service, Madigan Army Medical Center, Tacoma, Washington, USA.
Insights
Children with craniofacial anomalies often need airway interventions, including tracheotomy, especially in the first month of life. Associated medical conditions and feeding issues increase the risk of airway obstruction.
Area of Science:
- Pediatric medicine
- Craniofacial surgery
- Respiratory medicine
Background:
- Craniofacial anomalies (CFA) are congenital conditions affecting facial bone development.
- These anomalies can lead to significant airway obstruction in affected children.
- Management of airway issues in pediatric CFA is critical for patient outcomes.
Purpose of the Study:
- To describe the airway interventions required for managing pediatric patients with craniofacial syndromes.
- To evaluate the types and duration of airway management needed.
- To identify factors associated with airway obstruction in this population.
Main Methods:
- Retrospective study of 109 pediatric patients with craniofacial syndromes involving the midface and mandible.
- Review of medical records to assess airway intervention, duration, and associated conditions.
- Analysis of factors predisposing to airway problems and required treatments.
Main Results:
- 65 out of 109 patients required airway management, primarily within the first month of life.
- Interventions ranged from simple positioning to tracheotomy.
- Nineteen patients underwent tracheotomy; associated medical conditions and feeding difficulties were linked to airway obstruction.
Conclusions:
- Pediatric patients with craniofacial anomalies frequently require airway management.
- Early intervention is often necessary, with tracheotomy being a significant procedure for severe cases.
- Associated medical comorbidities and feeding challenges are key factors in the development of airway obstruction.
Abstract:
Craniofacial anomalies (CFA) predispose children to airway obstruction. A retrospective study was conducted to describe airway intervention required to manage patients with craniofacial syndromes and diseases involving the midface and mandible (i.e., Pierre Robin, Apert, Treacher Collins, Saethre-Chotzen, CHARGE, Nager, Stickler, Goldenhar, and Pfeiffer). The type of airway intervention, duration of intervention, and associated physical and medical conditions were evaluated. One hundred nine patients had charts available for review and met inclusion criteria. Sixty-five of these patients required airway management, most commonly in the first month of life, ranging from positioning to tracheotomy. Nineteen patients required a tracheotomy. Associated medical conditions and feeding difficulties were associated with airway obstruction. This study evaluates factors that predispose children with CFA to have airway problems that need treatment, as well as the types of airway management that are necessary.