2023 Volume 69 Issue 5 Pages 373-378
Congenital laryngeal atresia is one of the causes of congenital high airway obstruction syndrome (CHAOS). In recent years, there have been an increasing number of cases in which patients with CHAOS could be rescued by tracheotomy without cutting the umbilical cord (ex utero intrapartum treatment: EXIT). We report a case of congenital laryngeal atresia in which tracheostomy was performed without cutting the umbilical cord. CHAOS was suspected based on fetal ultrasonography at 20 weeks of gestation, and fetal MRI showed a nodular structure measuring 7 × 5 mm on the caudal side of the epiglottis. Based on these findings, a diagnosis of CHAOS was made. The infant was delivered at 35 weeks and 0 days of gestation by caesarean section with tracheotomy under EXIT. She had a birth weight of 1,945g and an Apgar score of 4 at 1 minute and 5 at 5 minutes. A postnatal examination revealed no complications other than laryngeal atresia, and she was discharged home at 190 days of age. At 1 year and 3 months of age, the patient had repeated colds, her respiratory condition worsened, and she was discharged from the hospital after her death.
