A retrospective analysis of airway endoscopy in patients less than 1-month old

Objectives: To review the authors' experience with neonates who underwent endoscopy over an 8-year period. Study Design: Retrospective review ina tertiary care children's hospital. Methods: Sixty-two neonates who underwent endoscopy were reviewed. Results: Common indications for endoscopy were stridor (56%), apnea/cyanotic episodes (30%), and feeding difficulty (23%). Laryngeal abnormalities were the most frequent finding, including laryngomalacia (19%), glottic edema (19%), and vocal cord paralysis (13%). Pierre Robin sequence was the most common associated anomaly. Forty-eight neonates (77.4%) had more than one endoscopic finding. Gastroesophageal reflux diagnosed by barium swallow or esophageal pH monitoring was found in 34%. Gastroesophageal reflux was the only identifies etiologic factor in four cases. Computed tomography and magnetic resonance imaging provided less information than endoscopy. Conclusions: Endoscopy in symptomatic neonates can determine etiology of distress most of the time. Multiple diagnoses were found in 77.4% of the neonates, emphasizing the need for a thorough aerodigestive tract examination. Concomitant diagnoses including gastroesophageal reflux, congenital heart disease, and pulmonary disease were found in 87.1% of neonates. Neonates have a higher likelihood of having multiple lesions in the aerodigestive tract as compared with older infants or children.