Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
BMC Pediatr. 2023 Nov 28;23(1):600. doi: 10.1186/s12887-023-04436-w.
Early-onset pharyngeal airway collapse (PAC) in infants, which presents with onset within 6-months old is relatively rare. This disease has not been given enough attention in clinic. The aim of this study was to explore the clinical features, endoscopic findings and outcomes of early-onset PAC in infants.
The children of PAC with onset within 6-months old were included. A retrospective study was conducted.
(1) Total 26 cases were included. The age of onset was neonatal period in 20 cases, 1 to 3-months old in 5 cases, and 4 to 6-months old in 1 case. (2) The main clinical manifestations were noisy breathing (26/26), suprasternal retraction (18/26), snoring (14/26) and hypoxic episode (13/26). (3) Based on the endoscopic findings, collapse at the retropalatal level was most common (24/26). (4) Twelve cases underwent pharyngolaryngeal CT examination, which revealed abnormal findings in 7 cases. (5) Fifteen cases were accompanied with the other airway malformations. (6) In the group with comorbidities of cerebral impairment or craniofacial abnormalities, 1 case was lost to follow up, 4 cases died, and 10 cases survived, in which 9 cases had neurodevelopmental disorders. In the group without comorbidities, 2 cases were lost to follow up, 9 cases survived, in which 1 case had neurodevelopmental disorders. The incidence of poor prognosis including death and neurodevelopmental disorders was significantly higher in the group with comorbidities than that without comorbidities (P<0.01). (7) An symptomatic improvement of PAC was found in the majority of the survived cases (18/19) with age.
Early-onset PAC in infants usually exhibits varying degrees of relief with age, whereas the cases with comorbidities had a poor prognosis.
早发性咽腔气道塌陷（PAC）在婴儿中较为罕见，其发病时间在 6 个月以内。该疾病在临床上尚未得到足够重视。本研究旨在探讨婴儿早发性 PAC 的临床特征、内镜表现及结局。
纳入发病时间在 6 个月以内的 PAC 患儿，采用回顾性研究方法。
（1）共纳入 26 例患儿，发病年龄为新生儿期 20 例，13 个月 5 例，46 个月 1 例。（2）主要临床表现为呼吸音粗（26/26）、胸骨上窝凹陷（18/26）、打鼾（14/26）和低氧血症（13/26）。（3）根据内镜表现，最常见的为腭后水平塌陷（24/26）。（4）12 例行咽旁咽腔 CT 检查，其中 7 例存在异常。（5）15 例患儿合并其他气道畸形。（6）合并脑损伤或颅面畸形组，失访 1 例，死亡 4 例，存活 10 例，其中 9 例存在神经发育障碍；无合并症组，失访 2 例，存活 9 例，其中 1 例存在神经发育障碍。合并症组的不良预后（死亡和神经发育障碍）发生率显著高于无合并症组（P<0.01）。（7）随着年龄的增长，大多数存活患儿（18/19）的 PAC 症状得到改善。
婴儿早发性 PAC 通常随年龄增长而逐渐缓解，但合并症患儿预后较差。
