OBJECTIVETo investigate the causes of severe upper respiratory tract obstruction in neonates.

METHODSForty seven cases with severe dyspnea history were reviewed and retrospective analysis performed. Clinical manifestation, direct laryngoscope, CT, X-ray barium meal examination results and the treatment process were recorded.

RESULTSAmong 47 neonates, 41 cases were congenital diseases, accounting for 87.2% (41/47). In 41 cases, 15 cases were congenital laryngeal stridor, accounting for 31.9%, involving 6 cases accompanied by the gastroesophageal reflux. Fourteen cases were congenital upper respiratory tract cyst (10 cases of lingual root cyst, 3 cases of epiglottis cyst, 1 case of laryngeal cyst), accounting for 29.8%, in which 13 cases were misdiagnosis as congenital laryngeal stridor. Others were 6 cases of acute membrane laryngotracheobronchitis, 3 cases of congenital main respiratory tract stenosis, 2 cases of congenital laryngeal webs, 2 cases of vocal cord paralysis, 3 cases of Pierre Robin syndrome, 2 cases of Cri-du-chat syndrome. Except for 3 in 47 cases whose parents refused treatment, dyspnea in other 44 cases were relieved with inhaling oxygen and drug treatment, 37 case received tracheal intubation and sputum suction, 19 cases received direct laryngoscope or self-retaining laryngoscope operation.

CONCLUSIONSCongenital disease is the main cause of severe upper respiratory tract obstruction. For the neonates suffering from severe upper respiratory obstruction, finding out the cause and prompt treatment are essential for prognosis and reducing mortality.