0
Clinical Note |

Perinatal Management of Unanticipated Congenital Laryngeal Atresia

Michael S. Cohen, MD; Michael A. Rothschild, MD; Juan Moscoso, MD; Edward Shlasko, MD
Arch Otolaryngol Head Neck Surg. 1998;124(12):1368-1371. doi:10.1001/archotol.124.12.1368.
Text Size: A A A
Published online

Extract

Laryngeal atresia is one of the rarest congenital airway anomalies, with approximately 70 documented cases in the world literature. Many of these cases are postmortem reports, with only a few of these neonates having survived delivery, generally in 1 of 2 scenarios.

The first scenario involves prenatal diagnosis by the characteristic sonographic findings of the congenital high airway obstruction syndrome, including distended lungs, dilated airways, flattened diaphragms, and fetal hydrops.1 If airway obstruction is anticipated, the appropriate personnel and equipment to perform a rapid tracheotomy under fetal circulation can be assembled in the delivery room.2

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 1.

The emergency tracheotomy site. A curved endotracheal tube is placed in the distal airway (arrowhead), and a suction catheter is placed in the fistula in the posterior wall of the airway (arrow).

Graphic Jump Location
Place holder to copy figure label and caption

A contrast esophagram showing the fistula (black arrow) above the tracheotomy tube (white arrow). No distal second fistula was seen.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Endoscopic views of the laryngeal atresia and tracheoesophageal fistula. A, The supraglottic larynx, notable for a somewhat stunted epiglottis. B, Close view of the glottis, demonstrating the abnormally shaped cartilages over the posterior cricoid cartilage (arrows). C, An endotracheal tube has been passed through the fistula from the tracheotomy site, superiorly into the pharynx. The fistula communicates with the esophagus at the level of the cricopharyngeus (white arrow), just inferior to the posterior cricoid cartilage (black arrow).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 4.

Drawing of a sagittal section through the airway, demonstrating the fistula (arrow) passing caudal to the cricoid cartilage from the upper trachea into the esophagus at the level of the cricopharyngeus. There is no discernible pharyngoglottic duct through the glottis itself.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
PubMed Articles
Jobs
brightcove.createExperiences();