📋 Paediatrics
Airway Malformations in Children Laryngomalacia Subglottic Stenosis Congenital Lung Malformations and Foreign Body Aspiration in Paediatrics
Airway malformations in children are important causes of respiratory distress and stridor in infancy and early childhood. This detailed paediatrics guide explains congenital airway disorders including laryngomalacia, congenital subglottic stenosis, congenital lobar emphysema, congenital pulmonary adenomatoid malformation CPAM, and pulmonary sequestration. It also covers foreign body aspiration in children, its causes, clinical presentation, diagnosis and management. Learn about pathophysiology, symptoms such as stridor and respiratory distress, diagnostic investigations including bronchoscopy and CT imaging, and treatment options like surgical resection, bronchoscopy removal and supportive care. This resource is useful for medical students, paediatric residents, and healthcare professionals studying congenital airway anomalies and paediatric respiratory emergencies.
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Frequently Asked Questions
❓ What is laryngomalacia in infants?
Laryngomalacia is the most common congenital laryngeal anomaly in infants in which the supraglottic structures collapse inward during inspiration, causing inspiratory stridor. It usually appears in the first few weeks of life and often resolves spontaneously by 12 to 18 months of age.
❓ What are the typical symptoms of laryngomalacia?
Typical symptoms include inspiratory stridor, noisy breathing that worsens when the infant is supine or feeding, improvement when the infant is prone, feeding difficulty, and in severe cases apnea or failure to thrive.
❓ What is congenital subglottic stenosis?
Congenital subglottic stenosis is a narrowing of the airway below the vocal cords present at birth. It causes biphasic stridor, recurrent croup, and respiratory distress due to reduced airway diameter.
❓ How is congenital subglottic stenosis diagnosed?
The diagnosis is confirmed using rigid bronchoscopy or laryngoscopy, which directly visualizes narrowing of the subglottic airway. CT imaging may also help evaluate airway anatomy.
❓ What is congenital lobar emphysema?
Congenital lobar emphysema is a developmental lung disorder characterized by overinflation of a lung lobe due to bronchial cartilage weakness or airway obstruction, leading to air trapping and respiratory distress in neonates.
❓ Which lung lobe is most commonly affected in congenital lobar emphysema?
The left upper lobe is the most commonly affected lobe, followed by the right middle lobe.
❓ What is congenital pulmonary adenomatoid malformation CPAM?
Congenital pulmonary adenomatoid malformation CPAM is a developmental lung lesion in which abnormal cystic lung tissue replaces normal alveoli, leading to respiratory distress, recurrent infections, or prenatal detection on ultrasound.
❓ What is pulmonary sequestration?
Pulmonary sequestration is a congenital lung anomaly in which a mass of nonfunctional lung tissue has no connection with the tracheobronchial tree and receives its blood supply from the systemic circulation, usually the aorta.
❓ How does foreign body aspiration occur in children?
Foreign body aspiration occurs when a child inhales objects such as peanuts, seeds, small toys, or food particles into the airway, causing obstruction, coughing, wheezing, or respiratory distress.
❓ What is the most common site of foreign body lodgment in the airway?
The right main bronchus is the most common site because it is wider, shorter, and more vertical than the left bronchus.
❓ What is the gold standard treatment for airway foreign body aspiration in children?
Rigid bronchoscopy is the gold standard for both diagnosis and removal of airway foreign bodies in children.
❓ What complications can occur if a foreign body remains in the airway?
If untreated, complications may include recurrent pneumonia, lung abscess, bronchiectasis, chronic cough, and in severe cases life threatening airway obstruction.