Motnje dihanja pogosto nastopijo pri novorojenčkih zaradi specifičnih anatomskih in fizioloških razmer v zgornjih dihalih. Pomembno je, da motnje čimprej opazimo in ustrezno opredelimo. Najpomembnejšo vlogo pri tem ima pediater neonatolog. S podrobno anamnezo in kliničnim pregledom pridobi osnovne podatke, ki so bistveni za nadaljnjo izbiro diagnostičnih postopkov. Če sumi na zaporo v zgornjih dihalih, ima pomembno vlogo tudi specialist otorinolaringolog. Najprej se je treba odločiti, ali motnja novorojenčka akutno ogroža ali ne. Polisomnografija zagotovi pomembne podatke, ki pojasnijo vrsto in jakost motnje dihanja novorojenčka. Ob sumu na obstrukcijo na območju zgornjih dihal, so na voljo naslednje diagnostične metode: ambulantna fleksibilna nazolaringoskopija, endoskopska ocen zgornjih dihal v sedaciji pri spontanem dihanju, rigidna laringoskopija, fiberendoskopska ocena požiranja in slikovna diagnostika (rentgenski posnetek v lateralni projekciji s cefalometrijo, CT ali MRI). Cilj je pridobiti čimbolj popolno informacijo o tipu, lokaciji in jakosti zapore v zgornjih dihalih, ki povzroča motnjo dihanja, da se multidisciplinarni tim lahko čim lažje in čim ustrezneje odloča o terapevtskih možnostih za bolnika.
Otorhinolaryngological Diagnostic Methods in the Identification of Breathing Disorders in Neonates
Breathing disorders in neonates are common due to specific anatomical and physiological conditions of the upper respiratory tract. It is essential to detect and define them as soon as possible. Neonatal pediatricians play a critical part in this process as they collect the basic data to assist with further diagnostic options by thorough medical history-taking and clinical evaluation. In cases of suspected upper airway obstruction, ear, nose and throat (ENT) specialist joins the multidisciplinary team. First, it is necessary to assess whether or not the condition poses an immediate risk to the neonate. Polysomnography (PSG) provides the team with important information to define the type and significance of neonatal breathing disorder. The following diagnostic methods are available in suspected upper airway obstruction: outpatient flexible nasolaringoscopy, drug-induced sleep endoscopy (DISE), rigid direct laryngoscopy, fiberoptic endoscopic evaluation of swallowing (FEES), lateral cephalometric radiograph, coputed tomography (CT), and magnetic resonance imaging (MRI). The aim is to obtain as complete information as possible on the type, location and severity of the upper airway obstructin, so that the multidisciplinary team can make the best and most appropriate decisions about the therapeutic options for the patient.