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Case Report

BTDMJB. 2006; 2(3): 104-105

Cause of severe respiratory distress in a newborn: a case of laryngo-tracheomalacia

Serdar Cömert, Ayça Vitrinel, N Ayça Gül, Feza Aksoy, Yasemin Akın, Turgut Ağzıkuru, Gülay Çiler Erdağ.

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.

Key words: Neonate, respiratory distress, laryngomalacia, tracheomalacia

Article Language: Turkish English

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