Prevention and treatment of upper airway obstruction in infants and children.

This review examines some of the recent advances made in the prevention and treatment of upper airway obstruction in infancy and childhood. In some instances, the advances are the result of experimental studies that corroborate or refute therapeutic notions that had been adopted prematurely. Studies performed in the past few years, for instance, have demonstrated that both systemic and local corticosteroid treatments are indeed effective in the treatment of viral croup. In contrast, other studies carried out in the same period raise doubts about the usefulness of these medications in the prevention of postextubation laryngeal edema. In other instances, the advances are the result of pioneering efforts to correct anatomical defects, usually congenital, that cause severe airway obstruction. Tracheal and laryngeal stenoses and craniofacial deformities, which only 5 years ago would have been palliated by tracheotomy, undergo now routine primary correction. Despite all these advances, upper airway obstruction remains an important source of morbidity and mortality in early childhood.