ENT - Pediatric airway Flashcards
how does the pediatric airway differ from the adult airway? why?
- higher in neck (C1/2 vs C3/4)
- epiglottis sits behind soft palate
- funnel shaped
- CRICOID is the most NARROW point (vs nose)
what allows kids to feed and breath at the same time (obligate nasal breathing)?
high location and position of epiglottis
is nasal cavity obstruction life threatening at birth?
yes
how is nasal cavity obstruction diagnosed?
- nasal canullas passed at birth
- relief with cry
what can obstruct the nose at birth?
- choanal atresia
- nasal piriform aperture stenosis
- bilateral nasal lacrimal duct cysts (most common)
- neoplastic (encephalocele, dermoid, glioma)
encephalocele, dermoid, glioma are derived from what germ layer?
neuroectoderm
bilateral nasal lacrimal duct cysts cause obstruction at what level?
nasal cavity
piriform stenosis can represent a form of ____________ and can be associated with a central ____________
- holoprosoencephaly
- mega-incisor
what is the most COMMON source of airway (nasal) obstruction?
rhinitis of infancy
what is the most LETHAL form of pediatric airway obstruction?
choanal atresia
what are the major conditions that affect the oropharynx and hypopharynx airways?
- adenotonsillar hypertrophy
- pharyngeal wall infections
- neoplasms
- vascular malformations
what is the most common source of airway problems that occur in the oropharynx and hypopharynx?
adenotonsillar hypertrophy
what is the most common cause of pediatric stridor / supraglottic obstruction / general airway problems?
laryngomalacia
then vocal cord paralysis
(then subglottic stenosis)
laryngomalacia usually resolves by what age?
1 year
what is the best way to diagnose supraglottic structures?
laryngoscopy (endoscopy)
thumbprint sign is see in what condition?
epiglottitis
in congenital bilateral vocal fold paralysis you should evaluate the ___________ for ______________
- foramen magnum
- chiari malformation
what is the most common neoplasm of the vocal fold?
recurrent respiratory papillomatosis
subglottic stenosis is diagnosed in absence of airway manipulation because _________
it is congenital
biphasic stridor by 6 months is usually due to ___________
subglottic hemangioma
most common neoplasm in infant airway is _________
subglottic hemangioma
tracheomalacia sometimes associated with __________
TE fistula
what questions should be asked for tracheomalacia?
- is it a tracheal problem? (TE fistula)
- is it an external problem? (vascular ring, mediastinal mass)
how do you make the diagnosis for tracheomalacia?
- looking
- bronchoscopy (endoscopy but asleep)
- CXR can be important
- swallow study
aspiration in foreign body obstruction is most commonly due to _____________
food particles
ingestion is most commonly a _______
coin
the subglottic edema in croup mimics _________
subglottic stenosis
