Airway Management in Children with Craniofacial Anomalies

TLDR

Craniofacial anomalies predispose children to airway obstruction. This retrospective study describes the airway interventions required for children with craniofacial syndromes and evaluates factors that predispose them to airway problems and the types of management needed. The authors reviewed chart data on intervention type, duration, and associated physical and medical conditions. Of 109 patients, 65 required airway management—most within the first month of life—with interventions ranging from positioning to tracheotomy, 19 of whom needed tracheotomy, and feeding difficulties and other medical conditions were linked to obstruction.

Abstract

Craniofacial anomalies (CFA) predispose children to airway obstruction. A retrospective study was conducted to describe airway intervention required to manage patients with craniofacial syndromes and diseases involving the midface and mandible (i.e., Pierre Robin, Apert, Treacher Collins, Saethre-Chotzen, CHARGE, Nager, Stickler, Goldenhar, and Pfeiffer). The type of airway intervention, duration of intervention, and associated physical and medical conditions were evaluated. One hundred nine patients had charts available for review and met inclusion criteria. Sixty-five of these patients required airway management, most commonly in the first month of life, ranging from positioning to tracheotomy. Nineteen patients required a tracheotomy. Associated medical conditions and feeding difficulties were associated with airway obstruction. This study evaluates factors that predispose children with CFA to have airway problems that need treatment, as well as the types of airway management that are necessary.