Allergy Asthma Respir Dis.  2014 Mar;2(1):70-74. 10.4168/aard.2014.2.1.70.

Analysis of respiratory problems in CHARGE syndrome: a single center study

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kmaped@skku.edu
  • 2Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.
  • 3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
CHARGE syndrome consists of multiple malformation including coloboma, heart defect, choanal atresia, growth or developmental retardation, genital anomalies, and ear anomalies. The aim of this study was to evaluate the respiratory problems in children with CHARGE syndrome.
METHODS
Out of 9 patients with CHARGE syndrome, medical records from 8 patients showing respiratory distress or respiratory failure were retrospectively reviewed. We investigated the causes of respiratory problems by physical examination, endoscopy, echocardiogram, computed tomography, rigid bronchoscopy, swallowing test, and 24-hour impedence monitoring.
RESULTS
Five patients required endotracheal intubation soon after birth due to bilateral choanal atresia (n=2) and congenital heart diseases (n=3). Three patients were intubated within a month because of surgery for complex heart diseases (n=2) or recurrent apnea (n=1). Tracheostomy was performed in 3 patients who showed primary or secondary subglottic stenosis. Among 8 patients who had aspiration or respiratory distress after feeding, cricopharyngeal incoordination and gastroesophageal reflux disease were found in 7 and 2 children, respectively. One patient died of aspiration during oral feeding.
CONCLUSION
Patients with CHARGE syndrome manifest respiratory distress or failure due to various causes including congenital anomaly in the airway, cardiac anomaly, neurologic or gastrointestinal problems. Therefore, pediatricians should be alert to the respiratory symptoms and signs in CHARGE syndrome and take active intervention from the birth to improve their long-term prognosis.

Keyword

CHARGE syndrome; Feeding methods; Choanal atresia; Subglottic stenosis

MeSH Terms

Apnea
Ataxia
Bronchoscopy
CHARGE Syndrome*
Child
Choanal Atresia
Coloboma
Constriction, Pathologic
Deglutition
Ear
Endoscopy
Feeding Methods
Gastroesophageal Reflux
Heart
Heart Diseases
Humans
Intubation, Intratracheal
Medical Records
Parturition
Physical Examination
Prognosis
Respiratory Insufficiency
Retrospective Studies
Tracheostomy

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