A case of laryngeal atresia (congenital high airway obstruction syndrome) with chromosome 5p deletion syndrome rescued by ex utero intrapartum treatment.
The authors report a case of laryngeal atresia (congenital high airway obstruction syndrome [CHAOS]) that was diagnosed prenatally. The patient underwent successfully tracheostomy by ex utero intrapartum treatment (EXIT). The fetal ultrasonography and magnetic resonance imaging MRI showed a typical CHAOS pattern with expanded hyperechogenic lungs, inverted diaphragms, and a dilated trachea. Recently, 3 cases of prenatally diagnosed CHAOS were reported to be treated successfully by EXIT. The clinical manifestation and course of this case was not similar to these 3 cases. The 3 previous patients did not fare as well during gestation and were delivered earlier than that in our case. In our case, fetal hydrops was seen at 23 gestational weeks, but it gradually subsided and disappeared at 30 gestational weeks. The fetus was stable and well. After delivery at 39 weeks, the baby received respiratory assistance by ventilator assistance. After 3 days, she could breath well on her own. The patient also had chromosome 5p deletion syndrome and perineal groove. More experience in treating CHAOS cases with EXIT to fully estimate its clinical course and prognosis is needed.
Kanamori
Yutaka
Y
Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Kitano
Yoshihiro
Y
Hashizume
Kohei
K
Sugiyama
Masahiko
M
Tomonaga
Tetsuya
T
Takayasu
Hajime
H
Egami
Satoshi
S
Goishi
Keiji
K
Shibuya
Kazuhiko
K
Kawana
Yukiko
Y
Marumo
Genzo
G
Kikuchi
Akihiko
A
Kozuma
Shiro
S
Taketani
Yuji
Y
Sekiyama
Yushi
Y
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery*; D000328:Adult; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology; D008607:Intellectual Disability / Q000235:genetics; D007828:Laryngoscopy; D007830:Larynx / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D008168:Lung / Q000002:abnormalities / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011859:Radiography; D013577:Syndrome; D014132:Trachea / Q000002:abnormalities; D014139:Tracheostomy; D016216:Ultrasonography, Prenatal