1/4. Combination of renal agenesis with respiratory and alimentary tract atresia results in normal lung development.The VACTERL complex comprises renal agenesis and atresias of the alimentary and respiratory tracts. We report on a case with this combination causing severe oligohydramnios but with normal lung development. The likely protective mechanism for pulmonary development was an increase in alveolar pressure and reduced alveolar fluid loss due to the esophageal-tracheal malformation. This suggests the possible treatment of oligohydramnios by tracheal occlusion.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/4. Congenital high airway obstruction syndrome and airway reconstruction: an evolving paradigm.OBJECTIVES: To refine the classic definition of, and provide a working definition for, congenital high airway obstruction syndrome (CHAOS) and to discuss the various aspects of long-term airway reconstruction, including the range of laryngeal anomalies and the various techniques for reconstruction. DESIGN: Retrospective chart review. patients: Four children (age range, 2-8 years) with CHAOS who presented to a single tertiary care children's hospital for pediatric airway reconstruction between 1995 and 2000. CONCLUSIONS: To date, CHAOS remains poorly described in the otolaryngologic literature. We propose the following working definition for pediatric cases of CHAOS: any neonate who needs a surgical airway within 1 hour of birth owing to high upper airway (ie, glottic, subglottic, or upper tracheal) obstruction and who cannot be tracheally intubated other than through a persistent tracheoesophageal fistula. Therefore, CHAOS has 3 possible presentations: (1) complete laryngeal atresia without an esophageal fistula, (2) complete laryngeal atresia with a tracheoesophageal fistula, and (3) near-complete high upper airway obstruction. Management of the airway, particularly in regard to long-term reconstruction, in children with CHAOS is complex and challenging.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
3/4. Tracheal agenesis: management of the first 10 months of life.Tracheal agenesis is a potentially lethal congenital anomaly, appearing only at birth. We describe a newborn preterm infant who presented with immediate respiratory distress and no audible cry. There was almost complete tracheal agenesis with a very short segment of distal trachea (only two tracheal rings) arising from the anterior wall of the esophagus, before dividing into the mainstem bronchi. The anomaly was unsuspected prenatally, as the scan showed pyloric atresia and complex congenital cardiac disease. Despite the patient's difficult course, with correction of the rare-associated malformations (cardiac and gastrointestinal tract anomalies), the fact that the child is lively and neurologically normal for her age, requires that we now consider the patency of the airway and the possibility of surgical correction, in accordance with a good quality of life.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
4/4. Congenital defects of respiratory system among the children hospitalized in the clinic in years 1983-1989.Congenital defects of respiratory system in children constitute a small percentage of all innate defects. In 1983-1989 in the Clinic Pulmonology and Allergology Medical School in Warsaw hospitalized 2522 children. Authors recognized the congenital defects of respiratory system in 29 cases. The opinions of authors only a complex diagnostic examinations makes it possible in most of the cases to rapidly correct diagnosis and choose proper treatment.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |