Bronchoscopic findings of the suspected congenital upper airway anomalies

Objective: The objective of this study was to study the flexible bronchoscopic findings in children with suspected upper airway anomalies. Design: This study was a cross-sectional study. Setting: This study was conducted at the pediatric department of the tertiary care hospital. Participants: Children of both genders from 3 days to 310 days of age were enrolled in the study. Intervention: All studied patients underwent flexible bronchoscopy. Outcome Measure: The endpoint was to document the presence and type of upper airway abnormality and any associated lower airway abnormality. Results: A total of 58 patients of both genders were enrolled in the study. Of these, 31 were boys and 27 were girls. Median (interquartile range) age of the study population was 53 (26–100) days. The most common presenting symptom was stridor and the most common sign was a tracheal tug. The most common abnormality was congenital laryngomalacia (39.7%), followed by subglottic stenosis (17.2%), laryngeal web (6.8%), supraglottic cyst (3.4%), vocal cord palsy (3.4%), laryngeal cleft (3.4%), and subglottic hemangioma (3.4%). Concomitant lower airway abnormality was found in 8 (22%) patients. The most common abnormality was tracheomalacia (75%). Conclusion: We found that stridor is the most common symptom of congenital airway malformation. Laryngomalacia is the most common congenital upper airway malformation. Around half of the patients with abnormal bronchoscopy had anomalies other than laryngomalacia. About one-third of patients with laryngomalacia can have associated tracheomalacia.