Early-onset pharyngeal airway collapse in infant: a retrospective single-center study

Abstract

Background Early-onset pharyngeal airway collapse(PAL) in infant, which presents with onset within 6-months old is relatively rare, and 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 PAL in infant. Methods The children of PAL with onset within 6-months old were included, and a retrospective study was conducted. Results 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 underlying diseases 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 underlying diseases, 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 underlying diseases than that without underlying diseases(P＜0.01). 7. An symptomatic improvement of PAL was found in the majority of the survived cases(18/19) with age. Conclusions Early-onset PAL in infant usually exhibits varying degrees of relief with age, whereas the cases with underlying diseases had a poor prognosis.