206 Pediatric Tracheal Anomalies

Question 1

IV medication given prior to instrumentation of airway.

Dose:

Answer 1

IV Dexamethasone

0.5 mg/kg

Question 2

Radiographic study of choice for evaluating pediatric airway.

Answer 2

Axial CT

Question 3

Tracheal agenesis classifications

Answer 3

Type I: Proximal trachea absent, airway connects to distal TEF

II: carina arises from lower esophagus

III: mainstem bronchi arise from two separate anastomoses with esophagus

Question 4

Most common congenital anomaly of esophagus

Answer 4

Esophageal atresia, with or without fistula

Question 5

Types of EA

Which is the most common?

Answer 5

EA with proximal

With distal (most common)

With proximal and distal (least common)

without TEF

H type

Question 6

Diagnosis of tracheomalacia

Instrument:
Criteria:

Answer 6

Bronchoscopy

Decrease in luminal diameter greater than 50% at end expiration

Question 7

Primary vs Secondary tracheomalacia

Answer 7

Primary: intrinsic

Secondary: segmental collapse of airway; may be due to inflammation, breakdown of tracheal wall(prolonged intubation or tracheotomy)

extrinsic compression as result of complete or incomplete vascular rings

Question 8

Causes of acquired tracheal stenosis

Answer 8

Prolonged intubation
Tracheotomy
Previous surgery
Inhalational chemical burn injury 
Systemic disease e.g. Wegener’s

Question 9

Cantrell and Guild Classification of Tracheal Stenosis

Answer 9

I: generalized hypoplasia of entire trachea

II: funnel stenosis: normal proximal trachea with distal narrowing to carina

III: segmental stenosis with up to three rings involved