Congenital and acquired developmental problems of the upper airway in newborns and infants

AimTo review the current knowledge on congenital and acquired developmental problems of the upper airway in newborns and infants.Data synthesisCauses of airway obstruction include problems with the nasal airway (choanal atresia), craniofacial syndromes (Apert syndrome, Crouzon syndrome), problems with facial/tongue anatomy (Pierre-Robin syndrome), the tongue (Down syndrome), or the larynx (laryngomalacia, vocal cord palsy, subglottic stenosis, subglottic hemangioma), along with lower developmental problems (tracheo/bronchomalacia). After establishing a safe airway, a detailed assessment and appropriate management are necessary. Treatment may involve simple observation, conservative management, chest physiotherapy, CPAP ventilation, and surgery, urgently or in a second phase.ConclusionUpper airway diseases in neonates and infants may be life threatening, or challenging regarding diagnosis and management. There should be a very low threshold for referring these children, after establishing a safe airway, for a specialist opinion and care in a tertiary unit, if local facilities are limited or unavailable.