Among these infants, the posterior nasal choanae were patent in 10 patients at the time of tracheotomy. These feeding difficulties and airway problems were highly correlated. We encountered multiple, complicated airway abnormalities. Resection of aryepiglottic folds was inadequate. Often, a tracheotomy could not be avoided in these patients, regardless of choanal patency.
Tracheotomy needs to be performed early to avoid hypoxic events.
In some selected patients, ventilation using bilevel positive airway pressure may be an alternative. Arch Otolaryngol Head Neck Surg. Accepted for publication August 11, 1998. Presented at the 13th Annual Meeting of the American Society of Pediatric Otolaryngology, Palm Beach, Fla, May 13, 1998. All rights reserved.