Evaluation of the Neonatal Airway: Laryngoscopy and Bronchoscopy

Abstract

This chapter is designed to provide instruction on neonatal airway evaluation. The difficulty of this task was well described in 1838 by Porter who said “There is perhaps no kind of disease covered by greater darkness or posing more difficulties to the practitioner than those of the larynx and the trachea” [Heinrich D. Becker. A short history of bronchoscopy: introduction to bronchoscopy. Cambridge: Cambridge University Press; 2009. p. 1–16]. Fortunately, as instrumentation and visualization techniques have improved so has our ability to directly evaluate the structural anatomy, function, and physiology of the neonatal airway. In evaluating the neonatal airway, a comprehensive history and complete physical examination are critical. Evaluation of the neonatal patient including history and physical examination, imaging, and direct examination are very different than in an adult patient. Once the history and physical point to potential airway pathology it is crucial to determine the area of obstruction so as best to correct it. Operative endoscopy and flexible fiberoptic endoscopy are indispensable tools for providing diagnostic information as well as allowing access for treatment.