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Congenital high airway obstruction syndrome and airway reconstruction: an evolving paradigm Hartnick CJ; Rutter M; Lang F; Willging JP; Cotton RTArch Otolaryngol Head Neck Surg 2002[May]; 128 (5): 567-70OBJECTIVES: To refine the classic definition of, and provide a working definition for, congenital high airway obstruction syndrome (CHAOS) and to discuss the various aspects of long-term airway reconstruction, including the range of laryngeal anomalies and the various techniques for reconstruction. DESIGN: Retrospective chart review. PATIENTS: Four children (age range, 2-8 years) with CHAOS who presented to a single tertiary care children's hospital for pediatric airway reconstruction between 1995 and 2000. CONCLUSIONS: To date, CHAOS remains poorly described in the otolaryngologic literature. We propose the following working definition for pediatric cases of CHAOS: any neonate who needs a surgical airway within 1 hour of birth owing to high upper airway (ie, glottic, subglottic, or upper tracheal) obstruction and who cannot be tracheally intubated other than through a persistent tracheoesophageal fistula. Therefore, CHAOS has 3 possible presentations: (1) complete laryngeal atresia without an esophageal fistula, (2) complete laryngeal atresia with a tracheoesophageal fistula, and (3) near-complete high upper airway obstruction. Management of the airway, particularly in regard to long-term reconstruction, in children with CHAOS is complex and challenging.|Abnormalities, Multiple/*surgery[MESH]|Child[MESH]|Humans[MESH]|Infant[MESH]|Laryngostenosis/*congenital/*surgery[MESH]|Male[MESH]|Plastic Surgery Procedures/*methods[MESH]|Pulmonary Disease, Chronic Obstructive/*congenital/*surgery[MESH]|Respiratory System Abnormalities/*surgery[MESH]|Retrospective Studies[MESH]|Syndrome[MESH]|Treatment Outcome[MESH] |
