الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
There is a wide range of congenital airway malformations. Congenital airway anomalies are a leading cause of morbidity and mortality in infants. Diagnosis and treatment are difficult because infants and children frequently present with multiple levels of airway anomalies. Neonatal and children intensive care units are taking care of an increasing number of children with these types of airway problems.
Diagnostic evaluation should include detailed antenatal history, clinical history, and physical examination. The presenting manifestations include recurrent stridor or wheeze, chronic cough, recurrent cyanotic episodes, life-threatening events, feeding difficulties with failure to thrive, failure of extubation, repeated chest infections, and associated other congenital anomalies.
Bronchoscopy is the most important tool in the clinical evaluation and management of pediatric airway disease. It is a minimally invasive and superior technique for direct visualization and evaluation of airways compared with other investigations.
This study was conducted on symptomatic children who underwent FFB at the bronchoscopy unit of Alexandria University Children’s Hospital between the first of January 2019 and the thirty-first of December 2019. The study aimed to determine the incidence of congenital airway malformations in children with airway-related manifestations.
Patient data included: Demographic data, antenatal and perinatal history, history of hospitalization and ventilation, source of referral, the onset of manifestations, presenting manifestations, associated co-morbidities, investigations, the technique of bronchoscopy, and anesthesia, bronchoscopic finding, treatment, and outcome.
Statistical analysis of information accomplished from the present study revealed that the incidence of congenital airway malformations in the studied population was 32%.
In the present study, it was found that the mean age of patients was 7 months and the youngest age was 8 days. Statistical analysis revealed a non-significant difference regarding the sex or residence of the patients.
The onset of clinical manifestations in about two-thirds of cases started since birth. Multiple manifestations were found in a large percentage of cases but the most common presentation was stridor followed by frequent aspiration and feeding intolerance.
In the studied children; ventilation in the form of NCPAP or PTV was observed in about 40% of the cases with a duration ranging from 4 days up to 120 days.
Congenital airway malformations were associated with other co-morbidities in about two- fifth of cases. Congenital heart disease was the main comorbidity observed in the studied cases.
Bronchoscopic findings revealed that laryngeal anomalies were the most common finding followed by tracheal anomalies. Laryngomalacia was the most frequent laryngeal anomaly followed by laryngeal cleft and subglottic stenosis while the most frequent tracheal anomaly was tracheomalacia.
The most common therapeutic strategy in management was watchful waiting; medications were used in about one-third of cases while surgical interference was used in about one-fifth of cases. Our results revealed that most cases improved without surgical intervention while a little number of cases were surgically managed