Congenital absent epiglottis causing aspiration in infant

Congenital absent epiglottis is a rare phenomenon which has variable clinical presentation. Most of the cases are asymptomatic and go unnoticed to the adulthood. Some neonates present with stridor and respiratory distress and sometimes the absence give rise to obstructive sleep apnoea features. Further some infants with absent epiglottis may present with significant aspiration of feeds as well as own secretions which occasionally may give rise to life threatening chest infections and growth retardation.
Management of aspirating infant is by swallowing therapy, altering the enteral feeding route (Nasogastric tube or percutaneous endoscopic gastrostomy (PEG)) or in rare occasions may require tracheostomy and supraglottic closure. The case discussed here is of a infant with aspiration detected to have absent epiglottis managed by swallowing therapy and PEG insertion.