6.2.5. Neonatology - Common Post-Natal Problems - ENT Flashcards
What are the Common ENT Problems in a Neonate?
- Airway Obstruction (See Respiratory)
- Choanal Atresia
- Pierre Robin Sequence
- Cleft Lip
- Cleft Palate
What is Choanal Atresia?
Nasal Obstruction
What are the Clinical Features of Choanal Atresia?
- Baby is Cyanotic at Rest
- “Pinks Up” with Crying
- If Bilateral, may need Oral Airway / Endotracheal Intubation
What are the Features of Pierre Robin Sequence?
- Very Small Jaw
- Tongue Obstruction
- (Possible) Cleft Pallate
What is the Complication / Treatment of Pierre Robin Sequence?
Respiratory Distress:
- Insert a Endotraceal Tube Nasally
- Humidified O2 / CPAP
- May need Endotracheal Intubation
What needs to be Felt and Visualise during Examination for Cleft Lip / Palate?
- Hard Palate
- Soft Palate
- Lip
Note - Use a Tongue Depressor and Light Source
What is the Relationship between Cleft Lip and Cleft Palate?
- 70% of cases of Cleft Lip will also have Cleft Palate
What are the Different Types of Cleft Lip?
- Incomplete (Small Gap) vs Complete (To Nose)
2. Unilateral vs Bilateral
Why do Cleft Lips form?
Maxillary and Medial Nasal Processes Fail to Merge
Note - This usually happens around 5 weeks of Gestation
Why do Cleft Palates form?
2 Plates of the Skull forming the Hard Palate fail to Merge
Note - This happens by 9 weeks Festation
What is Cleft Soft Palate associated with?
Cleft Lip
What are the Different Types of Cleft Palate?
- Complete - Soft + Hard Palate Involved
2. Incomplete - “Hole” in the Roof of the Mouth
What are the Cleft Lip / Palate Issues?
- Feeding Issues - Special Bottles / Teats
- Airway Problems
- Associated Abnormalities - Need Hearing Screen / Cardiac Echo
Note - Can still attempt Breast Feeding