Shatz Anat, Goldberg Shmuel, Picard Elie, Kerem Eitan
Pediatric Airways Clinic, Shaare Zedek Medical Center, Jerusalem 91031, Israel.
Ann Otol Rhinol Laryngol. 2004 Jun;113(6):483-7. doi: 10.1177/000348940411300613.
Pharyngeal wall inspiratory collapse (PWIC) is a dynamic obstruction of the air column proximal to the glottis during inspiration. Our objectives were to assess PWIC's incidence and its contribution to the symptoms of upper airway obstruction (UAO), and to propose indications for intervention. In a retrospective review of consecutive endoscopic evaluations and clinical data of 108 infants with UAO, PWIC was diagnosed in 50 infants (46%). The most common presenting symptom was apnea (52%). The PWIC was accompanied by 2 to 7 synchronous airway abnormalities, most frequently laryngomalacia (78%). Generalized hypotonia was the most common associated systemic finding (80%). Severe PWIC cases required bi-level positive airway pressure (BiPAP). The severity of PWIC, measured by a newly developed classification, was positively correlated to apnea (p < .05) and the need for BiPAP (p < .054). Spontaneous recovery occurred within 36 months. The incidence of PWIC among infants with UAO is high, and its role in UAO deserves greater recognition. Better diagnosis of PWIC will improve the treatment of UAO.
咽壁吸气性塌陷（PWIC）是吸气时声门近端气柱的动态阻塞。我们的目标是评估PWIC的发生率及其对上气道阻塞（UAO）症状的影响，并提出干预指征。在对108例UAO婴儿的连续内镜评估和临床数据进行回顾性研究中，50例婴儿（46%）被诊断为PWIC。最常见的症状是呼吸暂停（52%）。PWIC伴有2至7种同步气道异常，最常见的是喉软化（78%）。全身性肌张力减退是最常见的相关全身性表现（80%）。严重PWIC病例需要双水平气道正压通气（BiPAP）。通过新制定的分类法测量的PWIC严重程度与呼吸暂停（p < 0.05）和使用BiPAP的必要性（p < 0.054）呈正相关。36个月内出现自发恢复。UAO婴儿中PWIC的发生率很高，其在UAO中的作用值得更多关注。更好地诊断PWIC将改善UAO的治疗。
