[The airway management and treatment of newborns with micrognathia and laryngomalacia].
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
; 37(8): 622-625;631, 2023 Aug.
Article
en Zh
| MEDLINE
| ID: mdl-37551568
ABSTRACT
Objective:
To explore the perioperative airway management and treatment of newborns with micrognathia and laryngomalacia.Methods:
From January to December 2022, a total of 6 newborns with micrognathia and laryngomalacia were included. Preoperative laryngoscopy revealed concomitant laryngomalacia. These micrognathia were diagnosed as Pierre Robin sequences. All patients had grade â ¡ or higher symptoms of laryngeal obstruction and required oxygen therapy or non-invasive ventilatory support. All patients underwent simultaneous laryngomalacia surgery and mandibular distraction osteogenesis. The shortened aryepiglottic folds were ablated using a low-temperature plasma radiofrequency during the operation. Tracheal intubation was maintained for 3-5 days postoperatively. Polysomnographyï¼PSGï¼ and airway CT examination were performed before and 3 months after the surgery.Results:
Among the 6 patients, 4 required oxygen therapy preoperatively and 2 required non-invasiveventilatory support. The mean age of patients was 40 days at surgery. The inferior alveolar nerve bundle was not damaged during the operation, and there were no signs of mandibular branch injury such as facial asymmetry after the surgery. Laryngomalacia presented as mixed type type â ¡+ type â ¢. The maximum mandibular distraction distance was 20 mm, the minimum was 12 mm, and the mean was 16 mm. The posterior airway space increased from a preoperative average of 3.5 mm to a postoperative average of 9.5 mm. The AHI decreased from a mean of 5.65 to 0.85, and the lowest oxygen saturation increased from a mean of 78% to 95%. All patients were successfully extubated after the surgery, and symptoms of laryngeal obstruction such as hypoxia and feeding difficulties disappeared.Conclusion:
Newborns with micrognathia and laryngomalacia have multi-planar airway obstruction. Simultaneous laryngomalacia surgery and mandibular distraction osteogenesis are safe and feasible, and can effectively alleviate symptoms of laryngeal obstruction such as hypoxia and feeding difficulties, while significantly improving the appearance of micrognathia.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades de la Laringe
/
Osteogénesis por Distracción
/
Obstrucción de las Vías Aéreas
/
Laringomalacia
/
Micrognatismo
Tipo de estudio:
Observational_studies
Límite:
Humans
/
Infant
/
Newborn
Idioma:
Zh
Revista:
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
Año:
2023
Tipo del documento:
Article