Upper airway obstruction in neonatal period is rare. The obstructive airway anomalies that may cause respiratory distress in newborns are nasal-nasopharyngeal, oral-oropharyngeal, laryngeal and tracheal lesions. The most common symptom is stridor. Apnea, cyanosis, dyspnea, retractions, hypercapnia, feeding intolerance, abnormal cry and cough may be seen. The most common cause of stridor in neonatal period is laryngomalacia. Tracheomalacia is the most frequent type of tracheal airway anomaly. Though in mild cases treatment is conservative, severe cases may require surgery and tracheotomy.
A child born 3500 g. with spontaneous vaginal delivery, resuscitated in the delivery room with positive pressure ventilation was admitted to the Neonatology Unit with findings of hypotonia, cyanosis and inspiratory stridor. The child developed severe respiratory distress and due to worsening of blood gases she was intubated and ventilated with mechanical ventilation. Since severe laryngomalacia and tracheomalacia were observed during bronchoscopy, the child was operated to perform tracheostomy. With this case report we tried to emphasize that although laryngomalacia frequently observed during neonatal period usually disappears with conservative treatment, severe forms of the disease may cause severe respiratory distress in newborns and surgical treatment may also be needed in coexistance with tracheomalacia.
Keywords: Neonate, respiratory distress, laryngomalacia, tracheomalacia