Diagnosis of congenital airway abnormalities in children
Congenital lung lesions are relatively rare, but are an important consideration in any child with lung disease especially if the disease is recurrent or not resolving.
Some of these lesions cause severe symptoms shortly after birth while others may not present with symptoms for years. Antenatal ultrasound has made it possible to diagnose some of these lung lesions early, which were not possible to diagnose in the past.
Most congenital airway lesions are not diagnosed antenatally especially if they are not associated with cardiac lesions. Not every mother has an antenatal ultrasound in the developing world, which leads to late diagnosis of many congenital lesions with significant consequences.
There is a large number of different types of congenital airway abnormalities, but can be divided in structural abnormal airway, external compression and airway fistula. Long segment congenital tracheal stenosis presents early especially if associated with left pulmonary sling.
It is important that airway lesions are diagnosed early to determine the correct diagnosis and management. Plain chest X-ray may be very indicative of airway pathology and these should be evaluated to determine if the airways are visible, to determine narrowing, displacement or abnormal branching.
The diagnosis and management of children with airway pathology needs a team approach with skills needed in airway management, imaging, cardiology, bronchoscopy and airway surgery.
Congenital lesions are rare, but if undiagnosed, they may have significant consequences. These lesions are associated with abnormalities including congenital heart disease, which will complicate their diagnosis and management, particularly congenital airway malformations. Bronchoscopy plays an important role in diagnosis, intra-operative and post-operative management. Interventional bronchoscopy is useful in treating congenital airway abnormalities.
Received: Mar 1, 2023
Accepted: Mar 29, 2023
Published: Sept 1, 2023