Long-term outcomes after fetal therapy for congenital high airway obstructive syndrome

Saadai, Payam; Jelin, Eric B.; Nijagal, Amar; Schecter, Samuel C.; Hirose, Shinjiro; MacKenzie, Tippi C.; Rand, Larry; Goldstein, Ruth B.; Farrell, Jody A.; Harrison, Michael R.; Lee, Hanmin

doi:10.1016/j.jpedsurg.2012.03.015

Cited by 53 publications

(44 citation statements)

References 12 publications

(21 reference statements)

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“…Only six attempts of fetal therapy for CHAOS have been reported [5,6,7,8,14]. In the first case, Ward et al [5] attempted an open surgery fetal tracheostomy at 18 weeks' gestation, but there was a fetal death a few hours later.…”

Section: Discussionmentioning

confidence: 99%

“…The infant died at home 2 weeks later [8]. Finally, Saadai et al [14] reported 2 cases which underwent fetal bronchoscopy with an attempted wire tracheoplasty, i.e. a stiff guidewire that punctures the atretic segment of the trachea and is then removed.…”

Section: Discussionmentioning

confidence: 99%

“…The other case was presented at postnatal tracheoscopy with a tracheoesophageal fistula, and after several postnatal interventions the infant is free of tracheostomy, feeds by mouth and is able to phonate at 3 years of age. However, the authors acknowledge that they were not sure of having decompressed the airway during the fetal intervention [14]. …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Fetal Vocal Cords to Select Candidates for Successful Fetoscopic Treatment of Congenital High Airway Obstruction Syndrome: Preliminary Case Series

et al. 2013

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Objective: Congenital high airway obstruction syndrome (CHAOS) normally has a dire prognosis due to laryngeal atresia and association with other anomalies. However, rare cases with an isolated tracheal membrane have been described. We assessed systematically the larynx and vocal cords in fetuses with CHAOS, with the goal of identifying such cases and attempting fetoscopic deobstruction. Methods: Between 2008 and 2012, 7 cases of CHAOS were referred to our institution. The ultrasonographic aspect of the larynx and trachea was assessed. We report the ultrasound findings, necropsy findings of 6 cases and perinatal outcome in 1 case undergoing therapy. Results: In 6 cases, laryngeal atresia was presumed by ultrasound and confirmed by necropsy after termination of pregnancy. In 1 case, normal appearance of the vocal cords led to suspicion of a possible isolated tracheal web completely occluding the trachea. Fetoscopy confirmed the finding, thus the membrane was perforated. Lung size normalized and hydrops resolved. A normal fetus was delivered at term, requiring no respiratory support. At 9 months of age, the infant showed a normal laryngoscopy and was developing well. Conclusions: Systematic ultrasound assessment of the vocal cords can be performed in fetuses with CHAOS. We report the first case of long-term intact survival after fetoscopic airway deobstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Fetal Vocal Cords to Select Candidates for Successful Fetoscopic Treatment of Congenital High Airway Obstruction Syndrome: Preliminary Case Series

et al. 2013

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“…Definitive surgical correction of the trachea requires careful timing and coordination between otolaryngology, cardiothoracics, obstetrics, pediatric surgery and neonatal intensive care for maximal chances of survival [5]. In some cases, babies with proximal airway anomalies are also found to have an underlying chromosomal abnormality [6][7][8].…”

Section: Clinical Backgroundmentioning

confidence: 99%

Airway tissue engineering for congenital laryngotracheal disease

Lesage

Butler

Hynds

et al. 2016

Seminars in Pediatric Surgery

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“…The extent of any upper airway obstruction has important implications for the prognosis and success of potential fetal and postnatal surgical intervention. The majority of patients with subglottic stenosis and associated vocal fold fusion will have long-term moderate to severe dysphonia despite currently available surgical intervention 6,7 . Fetal laryngobronchoscopy has also been described for fetal airway anomalies other than CHAOS.…”

Section: Letters To the Editor Fetal Laryngoscopy To Evaluate Vocal Fmentioning

confidence: 99%

Fetal laryngoscopy to evaluate vocal folds in a fetus with congenital high airway obstruction syndrome (CHAOS)

Ruano¹,

Cass

Rieger³

et al. 2013

Ultrasound Obstet Gynecol

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Long-term outcomes after fetal therapy for congenital high airway obstructive syndrome

Cited by 53 publications

References 12 publications

Evaluation of Fetal Vocal Cords to Select Candidates for Successful Fetoscopic Treatment of Congenital High Airway Obstruction Syndrome: Preliminary Case Series

Evaluation of Fetal Vocal Cords to Select Candidates for Successful Fetoscopic Treatment of Congenital High Airway Obstruction Syndrome: Preliminary Case Series

Airway tissue engineering for congenital laryngotracheal disease

Fetal laryngoscopy to evaluate vocal folds in a fetus with congenital high airway obstruction syndrome (CHAOS)

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