The surgeons at Dallas ENT group are frequently asked to evaluate pediatric patients with noisy airway; or even neonates and infants with significant obstruction. In assessing a pediatric patient, we determine if the airway is abnormal. If so, we determine what the nature of the problem is and if the problem in the upper or lower airway.
During the initial consult, we will ask several questions to gather an in-depth case history about the nature of the airway issue. We will also evaluate the child’s airway through physical evaluation.
Most children referred to our practice are seen in the office within the first 2-3 months after birth with symptoms of mild airway noise. Our office provides the evaluation of the airway with a small fiber optic scope that can be easily passed through the nasal airway to assess the airway above the vocal cords.
The Laryngoscopy and Bronchoscopy Procedure
Children with more complicated airway issues will need to undergo a laryngoscopy and bronchoscopy. This involves evaluation of the airway under anesthesia with a lighted scope. Frequently, the lighted scope is passed below the vocal cords to determine any pathology or abnormality of the trachea or bronchi.
Respiratory distress and airway noise at 1-3 months may indicate a small vessel enlargement below the vocal cords, referred to as a subglottic hemangioma, but most commonly, laryngomalacia, is an immaturity of the cartilage of the epiglottis allowing for simple collapse during inspiration. With control of any reflux, the infant can outgrow the abnormality during the first 12 months of life.