ENT Dept., Lister Hospital, Stevenage, UK.
Early Hum Dev. 2012 Dec;88(12):951-5. doi: 10.1016/j.earlhumdev.2012.09.001. Epub 2012 Sep 25.
To review the current knowledge on congenital and acquired developmental problems of the upper airway in newborns and infants.
Causes of airway obstruction include problems with the nasal airway (choanal atresia), craniofacial syndromes (Apert syndrome, Crouzon syndrome), problems with facial/tongue anatomy (Pierre-Robin syndrome), the tongue (Down syndrome), or the larynx (laryngomalacia, vocal cord palsy, subglottic stenosis, subglottic hemangioma), along with lower developmental problems (tracheo/bronchomalacia). After establishing a safe airway, a detailed assessment and appropriate management are necessary. Treatment may involve simple observation, conservative management, chest physiotherapy, CPAP ventilation, and surgery, urgently or in a second phase.
Upper airway diseases in neonates and infants may be life threatening, or challenging regarding diagnosis and management. There should be a very low threshold for referring these children, after establishing a safe airway, for a specialist opinion and care in a tertiary unit, if local facilities are limited or unavailable.
回顾新生儿和婴儿上呼吸道先天性和获得性发育问题的现有知识。
气道阻塞的原因包括鼻气道问题（后鼻孔闭锁）、颅面综合征（Apert 综合征、Crouzon 综合征）、面部/舌解剖问题（Pierre-Robin 综合征）、舌（唐氏综合征）或喉（喉软化、声带麻痹、声门下狭窄、声门下血管瘤），以及下呼吸道发育问题（气管/支气管软化）。在建立安全气道后，需要进行详细评估和适当的管理。治疗可能包括简单观察、保守治疗、胸部物理治疗、CPAP 通气和手术，紧急或分阶段进行。
新生儿和婴儿的上呼吸道疾病可能危及生命，或在诊断和管理方面具有挑战性。如果当地设施有限或不可用，在建立安全气道后，应将这些儿童转诊至三级单位，由专家进行评估和治疗，转诊门槛应非常低。
