Content area
Full Text
The laryngeal web is a rare congenital anomaly resulting from an incomplete recanalization of the primitive larynx and should be suspected in any newborn with dysphonie cry with or without stridor and respiratory distress. The diagnosis is confirmed by endoscopic examination of the trachea (1). Chromosomal and cardiovascular anomalies are common in patients with a congenital laryngeal web. One of this is the deletion of chromosome 22ql 1. Accordingly, patients with a congenital laryngeal web should undergo genetic screening, including evaluation for a chromosome 22ql 1 deletion, and a thorough cardiovascular evaluation, including imaging of the aortic arch. Particular attention should be paid to identifying patients with the triad of a congenital laryngeal web, a chromosome 22ql 1 deletion, and cardiovascular anomalies (2). Here we report a preterm infant who was hospitalized for prematurity, respiratory distress and difficult intubation and advanced examinations showed laryngeal web and chromosome 22ql 1 deletion.
A1320 g, 30 week preterm female newborn, as the first child of a nonconsanguineous family was hospitalized for prematurity and respiratory distress. She was intubated but the process was difficult due to the narrow respiratory tract. In the follow up she was tried to be extubated but she could not tolerate it. She was referred to our tertiary NICU on the 6th day of life for bronchoscopic examination. Her lung graphy showed bilateral diffuse aeration of the lungs and there was no signs of respiratory distress syndrome on graphy. Her laboratory results were leukocyte: 15550/uL, hemoglobin: 13.2 g/dl, hematocrit: 38.6%, platelet: 289,000 /uL, C-reactive protein: 1.45 mg/dl, procalcitonin: 2.08 ng/ml, electrolytes included calcium were within the normal ranges and peripheric blood smear showed lymphocyte 34.6%, polymorphonuclear leukocyte 59.3%, monocyte 6.1%. On physical examination, the pathologic finding was only hypertelorism in addition to respiratory distress. Cranial ultrasonography (USG) was normal, abdominal USG revealed ectasia at left renal pelvicalyxial system. Cardiac echocardiography (ECHO) on the sixth day of life showed perimembranous ventricular septal defect, atrial septal defect (secundum) and bilateral peripheral pulmonary stenosis and control ECHO after the first month of life showed only small atrial septal defect. At the 7th day of life bronchoscopic examination and neck magnetic resonance imaging (MR) was performed and both of them revealed laryngeal web at the...