Skip to main content

Perioperative Care of Neonates with Airway Obstruction

  • Chapter
Perioperative Medicine in Pediatric Anesthesia

Abstract

Evaluation and treatment of the newborn presenting with airway dysfunction or obstruction demands close collaboration between the anesthesiologist, neonatologist, otolaryngologist, and craniofacial surgeons. Anesthesiologists may be involved in situations of neonatal lifesaving airway rescue, diagnostic processes under GA, or more definitive corrective treatment scenarios. These challenging patients may present with a difficult airway and necessitate the use of specific anesthetic techniques to provide optimal conditions for a precise diagnosis. A comprehensive evaluation of each patient is essential. This review will address most of the major pathologies of the newborn airways with the objective of helping to establish a rational plan for anesthesia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Bookman LB et al (2012) Neonates with tongue-based airway obstruction: a systematic review. Otolaryngol Head Neck Surg 146(1):8–18

    Article  PubMed  Google Scholar 

  2. Cladis F et al (2014) Pierre Robin Sequence: a perioperative review. Anesth Analog 119(2):400–412

    Article  Google Scholar 

  3. Hosking J et al (2012) Anesthesia for Treacher Collins syndrome: a review of airway management in 240 pediatric cases. Paediatr Anaesth 22(8):752–758

    Article  PubMed  Google Scholar 

  4. Ashokan CS, Sreenivasan A, Saraswathy GK (2014) Goldenhar syndrome-review with case series. J Clin Diagn Res 8(4):ZD17–ZD19

    PubMed Central  PubMed  Google Scholar 

  5. Bogusiak K et al (2014) Treatment strategy in Goldenhar syndrome. J Craniofac Surg 25(1):177–183

    Article  PubMed  Google Scholar 

  6. Healey D, Letts M, Jarvis JG (2002) Cervical spine instability in children with Goldenhar’s syndrome. Can J Surg 45(5):341–344

    PubMed Central  PubMed  Google Scholar 

  7. Weksberg R, Shuman C, Beckwith JB (2010) Beckwith-Wiedemann syndrome. Eur J Hum Genet 18(1):8–14

    Article  PubMed Central  PubMed  Google Scholar 

  8. Prada CE, Zarate YA, Hopkin RJ (2012) Genetic causes of macroglossia: diagnostic approach. Pediatrics 129(2):e431–e437

    Article  PubMed  Google Scholar 

  9. Handley SC et al (2013) Predicting surgical intervention for airway obstruction in micrognathic infants. Otolaryngol Head Neck Surg 148(5):847–851

    Article  PubMed  Google Scholar 

  10. Duval M et al (2007) Respiratory distress secondary to bilateral nasolacrimal duct mucoceles in a newborn. Otolaryngol Head Neck Surg 137(2):353–354

    Article  PubMed  Google Scholar 

  11. Burrow TA et al (2009) Characterization of congenital anomalies in individuals with choanal atresia. Arch Otolaryngol Head Neck Surg 135(6):543–547

    Article  PubMed  Google Scholar 

  12. Olney DR et al (1999) Laryngomalacia and its treatment. Laryngoscope 109(11):1770–1775

    Article  CAS  PubMed  Google Scholar 

  13. Adil E, Rager T, Carr M (2012) Location of airway obstruction in term and preterm infants with laryngomalacia. Am J Otolaryngol 33(4):437–440

    Article  PubMed  Google Scholar 

  14. Garritano FG, Carr MM (2014) Characteristics of patients undergoing supraglottoplasty for laryngomalacia. Int J Pediatr Otorhinolaryngol 78(7):1095–1100

    Article  PubMed  Google Scholar 

  15. Benjamin B, Inglis A (1989) Minor congenital laryngeal clefts: diagnosis and classification. Ann Otol Rhinol Laryngol 98(6):417–420

    Article  CAS  PubMed  Google Scholar 

  16. van der Doef HP et al (2007) Clinical aspects of type 1 posterior laryngeal clefts: literature review and a report of 31 patients. Laryngoscope 117(5):859–863

    Article  PubMed  Google Scholar 

  17. Rahbar R et al (2006) The presentation and management of laryngeal cleft: a 10-year experience. Arch Otolaryngol Head Neck Surg 132(12):1335–1341

    Article  PubMed  Google Scholar 

  18. Cohen SR (1985) Congenital glottic webs in children. A retrospective review of 51 patients. Ann Otol Rhinol Laryngol Suppl 121:2–16

    CAS  PubMed  Google Scholar 

  19. Benjamin B (1983) Chevalier Jackson Lecture. Congenital laryngeal webs. Ann Otol Rhinol Laryngol 92(4 Pt 1):317–326

    Article  CAS  PubMed  Google Scholar 

  20. Lyons M, Vlastarakos PV, Nikolopoulos TP (2012) Congenital and acquired developmental problems of the upper airway in newborns and infants. Early Hum Dev 88(12):951–955

    Article  PubMed  Google Scholar 

  21. Alshammari J, Monnier Y, Monnier P (2012) Clinically silent subdural hemorrhage causes bilateral vocal fold paralysis in newborn infant. Int J Pediatr Otorhinolaryngol 76(10):1533–1534

    Article  PubMed  Google Scholar 

  22. Manica D et al (2013) Association between length of intubation and subglottic stenosis in children. Laryngoscope 123(4):1049–1054

    Article  PubMed  Google Scholar 

  23. Myer CM 3rd, O’Connor DM, Cotton RT (1994) Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 103(4 Pt 1):319–323

    Article  PubMed  Google Scholar 

  24. Leaute-Labreze C et al (2008) Propranolol for severe hemangiomas of infancy. N Engl J Med 358(24):2649–2651

    Article  CAS  PubMed  Google Scholar 

  25. Broeks IJ et al (2013) Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol 77(11):1791–1800

    Article  PubMed  Google Scholar 

  26. Austin J, Ali T (2003) Tracheomalacia and bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management. Paediatr Anaesth 13(1):3–11

    Article  PubMed  Google Scholar 

  27. Kugler C, Stanzel F (2014) Tracheomalacia. Thorac Surg Clin 24(1):51–58

    Article  PubMed  Google Scholar 

  28. Jennings RW et al (2014) Surgical approaches to aortopexy for severe tracheomalacia. J Pediatr Surg 49(1):66–70; discussion 70–71

    Article  PubMed  Google Scholar 

  29. Valencia D et al (2011) Surgical management of distal tracheal stenosis in children. Laryngoscope 121(12):2665–2671

    Article  PubMed  Google Scholar 

  30. Pinsonneault C, Fortier J, Donati F (1999) Tracheal resection and reconstruction. Can J Anaesth 46(5 Pt 1):439–455

    Article  CAS  PubMed  Google Scholar 

  31. deLorimier AA et al (1990) Tracheobronchial obstructions in infants and children. Experience with 45 cases. Ann Surg 212(3):277–289

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Schmolzer GM et al (2013) Supraglottic airway devices during neonatal resuscitation: an historical perspective, systematic review and meta-analysis of available clinical trials. Resuscitation 84(6):722–730

    Article  PubMed  Google Scholar 

  33. Sims C, von Ungern-Sternberg BS (2012) The normal and the challenging pediatric airway. Paediatr Anaesth 22(6):521–526

    Article  PubMed  Google Scholar 

  34. Knights RM et al (2013) Airway management in patients with subglottic stenosis: experience at an academic institution. Anesth Analg 117(6):1352–1354

    Article  PubMed  Google Scholar 

  35. Davis PG, Henderson-Smart DJ (2001) Intravenous dexamethasone for extubation of newborn infants. Cochrane Database Syst Rev (4):CD000308. doi:10.1002/14651858.CD000308

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pierre Fiset MD, FRCPC .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Fiset, P., Daniel, S.J. (2016). Perioperative Care of Neonates with Airway Obstruction. In: Astuto, M., Ingelmo, P. (eds) Perioperative Medicine in Pediatric Anesthesia. Anesthesia, Intensive Care and Pain in Neonates and Children. Springer, Cham. https://doi.org/10.1007/978-3-319-21960-8_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-21960-8_18

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21959-2

  • Online ISBN: 978-3-319-21960-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics