scholarly journals Upper Airway Obstruction among the Paediatric Population in the University of Port Harcourt Teaching Hospital: The Place of Tracheostomy in the Management

2020 ◽  
pp. 46-52
Author(s):  
M. U. Ibekwe ◽  
Paul Ni
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Teaching Hospital ◽  
Upper Airway ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Age Group ◽  
Respiratory Difficulty ◽  
Port Harcourt ◽  
Paediatric Age

Background: The paediatric age group has very peculiar anatomic and physiologic airways therefore, obstruction which commonly occurs in this population, can pose serious challenges in this age group. Aim: To study the pattern and aetiology of acute upper airway obstruction in the paediatric age group in University of Port Harcourt teaching hospital and to determine the place of tracheostomy in the management. Patients and Methods: It is a descriptive hospital based study of all paediatric patients; aged 0-15 years with upper airway obstruction that presented to the ear, nose and throat department and the children emergency ward of university of Port Harcourt teaching hospital within the period of January 2014 to December 2019. Data on demographics, clinical presentations, causes and management were obtained using a Proforma. The diagnosis of upper airway obstruction is made in a child with any degree of respiratory difficulty with or without associated stridor or stertor arising from lesions above the thoracic inlet. Children with respiratory difficulty other than that from an upper airway obstruction were excluded from the study. Data obtained were analyzed with the IBM statistical package for social sciences SPSS version 20. Results were presented in simple descriptive forms with tables. Results: One hundred and sixty paediatric patients with upper air way obstruction with age ranging from 0-15 years were studied. The prevalence of upper airway obstruction was 1.87%. There were more males than females; male to female ratio was 1.2:1. Age group 4-7 years were the most affected, 43.75%. Foreign body aspiration was the commonest cause. Majority of the patients had tracheostomy done, 48.75%. Mortality was n=1(0.625%). Conclusion: Upper air way obstruction among the paediatric age group is still common with foreign body aspiration as a very important cause in our setting. The very young are the most affected and tracheostomy appears to still be the main option of securing airway in these cases in our environment.

Pediatric Upper Airway Obstruction

2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Peritonsillar Abscess ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Retropharyngeal Abscess ◽  
Anatomic Location ◽  
Bacterial Tracheitis

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor

Pediatric Upper Airway Obstruction

2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Peritonsillar Abscess ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Retropharyngeal Abscess ◽  
Anatomic Location ◽  
Bacterial Tracheitis

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor

Pediatric Upper Airway Obstruction

2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Peritonsillar Abscess ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Retropharyngeal Abscess ◽  
Anatomic Location ◽  
Bacterial Tracheitis

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 10 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor  

Management of Subglottic Foreign Bodies

1996 ◽  
Vol 105 (7) ◽  
pp. 541-544 ◽  
Author(s):  
David J. Halvorson ◽  
Christopher Mann ◽  
Robert M. Merritt ◽  
Edward S. Porubsky
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Clinical Features ◽  
Surgical Management ◽  
Foreign Bodies ◽  
Upper Airway ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Management ◽  
Actual Event

Foreign body aspiration is not an infrequent encounter in the practice of otolaryngology and requires immediate attention. The vast majority of foreign body aspirations occur in children less than 3 years of age, and the actual event of aspiration is frequently not witnessed. Although inhaled foreign bodies most often lodge in the bronchi, laryngotracheal foreign bodies also occur and are potentially more dangerous. Specifically, subglottic foreign bodies present unique clinical challenges. The diagnosis of subglottic foreign bodies is often difficult and they are commonly confused with other causes of upper airway obstruction. We present our experience with the diagnosis and management of seven patients with subglottic foreign bodies, who presented with an abnormal airway and whose problems were initially misdiagnosed. The radiographic and clinical features are discussed with a review of our surgical management.

Pediatric Upper Airway Obstruction

2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Peritonsillar Abscess ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Retropharyngeal Abscess ◽  
Anatomic Location ◽  
Bacterial Tracheitis

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor

Pediatric Upper Airway Obstruction

2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Peritonsillar Abscess ◽  
Foreign Body Aspiration ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Retropharyngeal Abscess ◽  
Anatomic Location ◽  
Bacterial Tracheitis

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor

Tracheotomy in the Preschool Population: Indications and Outcomes

2007 ◽  
Vol 137 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Lesley C. French ◽  
Christopher T. Wootten ◽  
Robert G. Thomas ◽  
Wallace W. Neblett ◽  
Jay A. Werkhaven ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Direct Result ◽  
First Year ◽  
Care Hospital ◽  
Age Group ◽  
First Year Of Life

OBJECTIVE: Although more tracheotomy procedures are performed within the first year of life than in any other age group, preschool-aged children requiring tracheotomy remain understudied. We characterize the indications and outcomes for patients between the ages of 3 and 6 years undergoing tracheotomy. METHODS: Out of 480 pediatric tracheotomy procedures performed at a tertiary-care hospital between 1988 and 2004, 15 patients underwent primary tracheotomy between 3 and 6 years of age. RESULTS: Most (60%) procedures were performed for pulmonary toilet. Upper-airway obstruction represented the second most common indication (40%), and trauma necessitated tracheotomy procedures more often than had been predicted (40%). The decannulation rate was 40%; 2 patients died. CONCLUSION: Trauma contributed to both upper-airway obstruction as well as requirements for pulmonary toilet. These procedures performed secondary to trauma will likely continue to increase. SIGNIFICANCE: Tracheotomy procedures in the preschool population remain uncommon; however, nearly half of those studied were performed as a direct result of otherwise preventable trauma.

The changing concepts of tracheostomy

1979 ◽  
Vol 93 (9) ◽  
pp. 899-907 ◽  
Author(s):  
D. K. Mukherjee
Keyword(s):  
Head Injury ◽  
Airway Obstruction ◽  
Developing Country ◽  
Teaching Hospital ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Main Indication ◽  
Near Future

SummayAN analysis of 110 tracheostomies done over a period of 4½ years in a teaching hospital in a developing country is presented in this paper. It will be interesting to note that upper airway obstruction leading to tracheostomy no longer holds the supreme position it used to hold only a short while ago. The main indication for the operation in this study has been—TETANUS. It is surmised that—in the near future—HEAD INJURY is going to be the prime indication for this operation.

Mediastinal tuberculosis in a 10-month-old child

2001 ◽  
Vol 115 (2) ◽  
pp. 161-163 ◽  
Author(s):  
Aftab Ahmed ◽  
Showkat Mirza ◽  
Michael P. Rothera
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Rare Case ◽  
Mediastinal Mass ◽  
Histological Analysis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Mediastinal Lymphadenopathy ◽  
X Rays ◽  
History Of

We report a rare case of mediastinal tuberculosis in a child who presented as a possible inhaled foreign body. A 10-month-old girl was admitted with a five-month history of cough, wheeze and problematic feeding, thought initially to be due to asthma. A clinical deterioration and subsequent X-rays suggested an inhaled foreign body. However, at direct laryngotracheobronchoscopy no foreign body was found and subsequent investigations revealed a subcarinal mediastinal mass. She underwent a thoracotomy and excision of the mass, the histological analysis of which revealed it to be of tuberculous origin. When a patient presents with symtoms of upper airway obstruction which are highly suggestive of a foreign body, other causes such as mediastinal tuberculosis must be borne in mind when no foreign body can be found. Although rare, cases of tuberculosis are apparently increasing and the otolaryngolgoist must be aware of its various manifestations and submit specimens for appropriate analysis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.

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