Upper Airway Obstruction among the Paediatric Population in the University of Port Harcourt Teaching Hospital: The Place of Tracheostomy in the Management

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M. U. Ibekwe
Paul Ni


Background: The paediatric age group has very peculiar anatomic and physiologic airways therefore, obstruction which commonly occurs in this population, can pose serious challenges in this age group.

Aim: To study the pattern and aetiology of acute upper airway obstruction in the paediatric age group in University of Port Harcourt teaching hospital and to determine the place of tracheostomy in the management.

Patients and Methods: It is a descriptive hospital based study of all paediatric patients; aged 0-15 years with upper airway obstruction that presented to the ear, nose and throat department and the children emergency ward of university of Port Harcourt teaching hospital within the period of January 2014 to December 2019. Data on demographics, clinical presentations, causes and management were obtained using a Proforma. The diagnosis of upper airway obstruction is made in a child with any degree of respiratory difficulty with or without associated stridor or stertor arising from lesions above the thoracic inlet. Children with respiratory difficulty other than that from an upper airway obstruction were excluded from the study.

Data obtained were analyzed with the IBM statistical package for social sciences SPSS version 20. Results were presented in simple descriptive forms with tables.

Results: One hundred and sixty paediatric patients with upper air way obstruction with age ranging from 0-15 years were studied. The prevalence of upper airway obstruction was 1.87%. There were more males than females; male to female ratio was 1.2:1. Age group 4-7 years were the most affected, 43.75%. Foreign body aspiration was the commonest cause. Majority of the patients had tracheostomy done, 48.75%. Mortality was n=1(0.625%).

Conclusion: Upper air way obstruction among the paediatric age group is still common with foreign body aspiration as a very important cause in our setting. The very young are the most affected and tracheostomy appears to still be the main option of securing airway in these cases in our environment.

Upper airway obstruction, paediatric, tracheostomy, foreign body

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How to Cite
Ibekwe, M. U., & Ni, P. (2020). Upper Airway Obstruction among the Paediatric Population in the University of Port Harcourt Teaching Hospital: The Place of Tracheostomy in the Management. International Journal of TROPICAL DISEASE & Health, 41(2), 46-52. https://doi.org/10.9734/ijtdh/2020/v41i230254
Original Research Article


Sasidaran K, Bansal A, Singh S. Acute upper airway obstruction. Indian J Pediatr. 2011;78(10):1256-1261.

Holinger LD. Evaluation of stridor and wheezing. In: Holinger LD, editor. Pediatric Laryngology and Bronchoesophagology. New York: Lippincott Raven. 1997;41-48.

Mandal A, Kabra SK, Lodha R. Upper airway obstruction in children. Indian J Pediatr. 2015;82(8):737-744

Bohadana A, Izbicki G, Kraman SS. Fundamentals of lung auscultation. N Engl J Med. 2014;370:744-751

Hammer J. Acquired upper airway obstruction. Paediatr Respir Rev. 2004;5 (1):25-33

Loftis L. Acute infectious upper airway obstruction in children. Semin Pediatr Infect Dis. 2006;17(1):5-10.

Holinger LD. Foreign bodies of the larynx trachea and bronchi. In: Bluestone, editor. Pediatric Otolaryngology. 2nd ed. WB Saunders; Philadelphia. 1990;1206-1214.

Raghu Raman TS, Dal Jit Singh, Jayaprakash DR, Raja LN. Airway obstruction in children. Med J Armed forces India. 1995;51(2):87-90.

Amusa YB, Akinpelu VO, Fadora SO, Agbakwuru EA. Tracheostomy in surgical practice: Experience in a Nigerian tertiary hospital. West Afr J Med. 2004;23(1):32-34.

Eziyi JA, Amusa YB, Olanrewaju MI, Adeniji AO, Olarinoye OT, Ameye SA. Tracheostomy in South Western Nigeria: Any change in pattern? J Med Med Sci. 2011;2(7):997-1002l.

Adoga AA, Ma’an MD. Indication and outcome of paediatric tracheostomy: results from a Nigerian Tertiary Hospital. BMC Surg. 2010;10:2.

Onotai LO, Ibekwe MU, George IO. Impacted foreign bodies in the larynx of Nigerian children. J Med Sci. 2012;3 (4):217-221.

Ibekwe MU, Onotai LO, Otaigbe B. Foreign body in the ear, nose and throat in children: A five year review in Niger Delta. Afr J Paediatr Surg. 2012;9(3):3-7.

Chan PW, Goh A, Lum L. Severe upper airway obstruction in the tropics requiring intensive care. Pediatr Int. 2001;43:53-57.

Ogunley AO, Nwaorgu OG, Sogebi OA. Upper airway obstruction in Nigeria: An aetiological profile and review of literature. Trop Doct. 2001;31(4):195-197.

Onotai LO, Etawo US. An audit of paediatric tracheostomies in Port Harcourt Nigeria. International J Med MedSci. 2012;2(7):148-153.

Cressman M. Diagnosis and management of croup and epiglottitis. PediatrClin North Am. 1994;41:265-276.

Geelhoed GC. Sixteen years of croup in a western Australian teaching hospital: Effects of routine steroid treatment. Ann Emerg Med. 1996;28(6):621-626.

Bjornson CL, Johnson DW. Croup in children. CMAJ. 2013;185(15):1317-1323.

Geelhoed G. chapter6.4 croup In: Cameron P, Browne G, Biswadev M, et al. eds. Textbook of Paediatric Emergency Medicine. 3rd edn. London, Elsevier; 2019.

Russell KF, Liang Y, O’Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;1:CD001955.

Gilyoma JM, Balumuka DD, Chalya PL. Ten year experiences with tracheostomy at a university teaching hospital in North western Tanzania: A retrospective review of 214 cases. World J Emerg Surg. 2011; 6(1):38

Lewis CW, Carron JD, Perkins JA, Sie KC, Feudtner C. Tracheostomy in paediatric patients: A National perspective Arch Otolaryngol Head Neck Surg. 2003;129 (5):523-529.

Fasunla AJ, Lasisi OA. Diagnostic challenges of laryngeal papillomatosis and its implication among children in developing country. Int J Pediatr Otorhinolaryngol. 2009;73(4):593- 595.

Lawrason A, Kavanagh K. Pediatric tracheotomy: Are the indications changing? Int J Pediatr Otorhinolaryngol. 2013;77(6):922-925

Berry JG, Graham RJ, Zhou J, Putney HL, O’Brien JE, Roberson DW, et al. Predictors of outcomes and hospital resource use of children after tracheotomy. Pediatrics. 2009;124(2):563-572.

Deutsch ES. Tracheostomy: Pediatric considerations. Respir Care. 2010;55(8): 1082-1090.