There is a wide range of congenital airway malformations. The reported incidence of congenital airway malformations is 0.1% to 2% of the population. Diagnosis and treatment are difficult because infants and children frequently present with multiple levels of airway anomalies and a lack of coordination. A combination of deficits may affect the airway including morphology, mucosa, bone, muscles, nerves, and cartilage. Congenital airway anomalies are a leading cause of morbidity and mortality in infants.
Diagnostic evaluation should include detailed antenatal history, clinical history, and physical examination. Further investigations will be needed if the following manifestations are present including; recurrent stridor or wheeze, chronic cough, recurrent cyanotic episodes, life-threatening events, feeding difficulties with failure to thrive, failure of extubation, associated other congenital anomalies, and repeated chest infections.Investigations include plain X-rays, laryngoscopy, bronchoscopy, ultrasound, high resolution CT scans, and MRI.
Bronchoscopy is the most important tool in the clinical evaluation and management of pediatric airway disease. It is a minimally invasive and superior technique for direct visualization and evaluation of airway anatomy and mucosa compared with other investigations.There is no absolute contraindication to perform bronchoscopy. Requirements for a safe bronchoscopy procedure include skilled personnel, suitable indication, and appropriate equipment.