LARYNGEAL ATRESIA IN THE NEWBORN - SURGICAL IMPLICATIONS

Congenital atresia of the larynx is a rare, life-threatening anomaly i n which early recognition and appropriate perinatal management are ess ential for survival. Few longterm survivors have been reported in the literature, with most documented cases studied at necropsy. The author s present a case of a full-term male newborn with Smith and Bain Type I laryngeal atresia, who has survived and developed normally during th e 10 months since birth. Rapidly progressive cyanosis following umbili cal cord occlusion, lack of phonation, and no air movement with respir atory efforts are typically present and should alert the clinician to the possibility of laryngeal atresia. Positive pressure ventilatory as sistance may be possible through a patent pharyngoglottic duct or trac heoesophageal fistula until a surgical airway is established. If this is not possible, emergent tracheostomy may be a lifesaving procedure i n the first minutes of life.