RECURRENT APPARENT LIFE-THREATENING EVENT RELIEVED BY GLOSSOPEXY

An infant with repaired esophageal atresia presented with several appa rent life-threatening events (ALTEs). He had upper airway instability, gastroesophageal reflux (GER), and tracheomalacia. Oxygen breathing t est results showed a modest increase in arterial PO2 consistent with t he development of an intrapulmonary shunt from absorption collapse of some hypoventilated areas of the lung. Glossopexy was followed by impr ovement in upper airway stability, normal oxygen test, and disappearan ce of ALTE. These findings support the concept that upper airway insta bility, obstructive apnea, lower airway instability, absorpion collaps e, massive intrapulmonary shunt, and ALTE are the result of a cascade reaction. The authors conclude that infants with ALTE associated with obstructive apnea and O-2 shunting require glossopexy to reduce the ri sk of sudden death. Copyright (C) 1996 by W.B. Saunders Company