2015-09-01-08 Laryngeal atresia © Shah www.thefetus.net

Laryngeal atresia

Jayprakash Shah, MD.

Rajni Hospital, Fetal Medicine center, Ahmedabad, India.

Following images and videos show a case of laryngeal atresia diagnosed at 20 weeks of gestation of a primigravida with non-contributive history.

Ultrasonographic examination revealed a fetus with normal biometry corresponding to 20 weeks of pregnancy. Fetal chest had a bell-shaped appearance due to enlarged and hyperechoic lungs. Trachea and bronchi were dilated, the heart was in the middle position. Diaphragm was inverted and fetal ascites was present.

Diagnosis of laryngeal atresia was made. The parents opted for the termination of the pregnancy.

Bilateral echogenic lungs are typically associated with congenital high airway obstruction syndrome (CHAOS). Tracheal dilatation up to the glottis region was suggestive of laryngeal atresia in our case.

Possible differential diagnoses may be:

1. Tracheal atresia

2. Tongue tumor - lymphangioma

3. Airway obstructing oropharyngeal tumors

4. Cystic adenomatoid malformation of the lungs (fetal ascites is not present)

Chromosomal abnormalities are usually not associated with the congenital high airway obstruction syndrome. If the finding is associated with microphthalmia, cleft lip / palate, congenital heart anomaly, bilateral or unilateral renal agenesis – Fraser syndrome is likely.