Cohen M S, Rothschild M A, Moscoso J, Shlasko E
Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029, USA.
Arch Otolaryngol Head Neck Surg. 1998 Dec;124(12):1368-71. doi: 10.1001/archotol.124.12.1368.
Unless ventilation is achieved within minutes of delivery, patients with congenital laryngeal atresia will not survive. There are 2 settings in which survival is more likely: a tracheotomy may be immediately performed in the delivery room, or a communication may exist between the airway and the pharynx, allowing for air exchange. In the latter case, there are no characteristic findings on prenatal sonography to suggest the diagnosis and to ensure that preparations for immediate tracheotomy are made. We describe a neonate with unanticipated laryngeal atresia and a high tracheoesophageal fistula. Ventilation was maintained first by face mask and then by esophageal intubation until a tracheotomy could be performed. This report provides detailed photodocumentation of the anomaly, discusses the mechanism of air exchange, reviews the relevant embryological development, and outlines a protocol for perinatal management of unanticipated laryngeal atresia.
除非在分娩后几分钟内实现通气，否则先天性喉闭锁患者将无法存活。有两种情况存活的可能性更大：可在产房立即进行气管切开术，或者气道与咽部之间可能存在连通，从而实现气体交换。在后一种情况下，产前超声检查没有特征性表现来提示诊断并确保做好立即进行气管切开术的准备。我们描述了一名患有意外喉闭锁和高位气管食管瘘的新生儿。首先通过面罩维持通气，然后通过食管插管维持通气，直到能够进行气管切开术。本报告提供了该异常情况的详细图片记录，讨论了气体交换的机制，回顾了相关的胚胎发育过程，并概述了意外喉闭锁围产期管理的方案。
