Fibreoptic bronchoscopic assessment of suspected congenital upper airway defects in infants under one year of age: A five-year retrospective analysis from a tertiary care centre in Eastern India

Background: Congenital defects of the upper airway in neonates and infants can lead to various degrees of respiratory obstruction depending on lesion location, severity, and coexisting conditions. Fibreoptic bronchoscopy (FOB) remains the most accurate diagnostic modality due to its ability to visually examine the tracheobronchial anatomy. Limited literature is available documenting FOB findings in infants under one year with suspected congenital upper airway defects.
Objectives: To evaluate bronchoscopic findings in infants suspected of having upper airway malformations.
Method: This retrospective single-centre study was carried out at the Institute of Child Health, Kolkata, from January 2019 to December 2024. A total of 122 infants aged 15 days to one year presenting with suspected upper airway obstruction underwent flexible bronchoscopy. Data on sex, clinical presentation, imaging (chest X-ray, echocardiogram), and FOB findings were analysed.
Results: Among 122 participants (65 males, 57 females), the predominant symptom was stridor. Laryngomalacia was the most frequent finding (42.6%), followed by subglottic stenosis (18.9%) and laryngeal web (9.8%). Coexisting lower airway issues were present in 27% of patients, predominantly tracheomalacia (75%).
Conclusions: Laryngomalacia was the commonest finding followed by subglottic stenosis and laryngeal web Coexisting lower airway issues were present in 27% of patients, predominantly tracheomalacia.