ABOHNS Complex Pediatric Otolaryngology key terms

The most common congenital laryngeal anomaly, in which flaccid supraglottic structures prolapse into the airway on inspiration, producing stridor that worsens with feeding, crying, or supine positioning and usually resolves by 12 to 18 months.

Surgical division or resection of tissue in the supraglottis, typically the aryepiglottic folds and sometimes the epiglottis or arytenoid mucosa, to relieve airway obstruction in severe laryngomalacia unresponsive to medical therapy.

A high-pitched, predominantly inspiratory sound caused by turbulent airflow through a narrowed extrathoracic airway, classically laryngeal; its pitch, timing, and response to position help localize the level of obstruction.

Weakness of tracheal cartilage causing excessive dynamic collapse of the airway, often with biphasic or expiratory stridor, frequently associated with prolonged intubation, vascular compression, or esophageal atresia.

Narrowing of the subglottis, most often acquired after endotracheal intubation, graded by the percentage of luminal obstruction and classified as membranous or cartilaginous; severe grades require open airway reconstruction.

A four-tier system classifying subglottic stenosis by the percent of luminal cross-sectional area obstructed, from grade I (up to 50 percent) through grade IV (complete obstruction), used to guide surgical decision-making.

A procedure in which the anterior cricoid cartilage and upper tracheal rings are divided to enlarge the subglottic airway, used to allow extubation in infants with acquired stenosis who would otherwise need a tracheostomy.

Open resection of a stenotic segment of cricoid and trachea with primary thyrotracheal anastomosis, typically for high-grade subglottic stenosis; requires careful recurrent laryngeal nerve protection and postoperative airway surveillance.

Open surgical enlargement of the laryngotracheal airway using cartilage grafts, usually costal cartilage, placed through an anterior, posterior, or combined split, often with a stent and temporary tracheostomy.

Recurrent airway papillomas caused by human papillomavirus, most often types 6 and 11, presenting with progressive hoarseness or stridor; juvenile-onset disease tends to be more aggressive and requires repeated debulking.

Respiratory papillomatosis with onset before age 12, often acquired perinatally from an infected birth canal, characterized by frequent recurrences, risk of airway obstruction, and potential spread to the distal tracheobronchial tree.

Simultaneous endoscopic evaluation of the larynx and tracheobronchial tree under general anesthesia with suspension instrumentation, the standard procedure for diagnosing and treating pediatric airway lesions.

Awake or sedated transnasal endoscopic examination of the pharynx and larynx with a flexible scope, useful for assessing dynamic airway function, vocal fold motion, and supraglottic collapse without general anesthesia.

Loss of vocal fold movement from recurrent laryngeal nerve injury, central neurologic disease, or idiopathic causes, presenting in infants as weak cry, stridor, or aspiration; bilateral paralysis may cause severe airway obstruction.

A congenital failure of fusion of the posterior larynx, ranging from interarytenoid notch clefts to extension through the cricoid and into the cervical trachea, causing aspiration, stridor, and recurrent pneumonia.

Creation of a surgical stoma between the anterior trachea and skin to secure the airway, used in children for prolonged ventilation, upper airway obstruction, or airway protection; pediatric care requires attention to tube size, maturation, and decannulation planning.

Surgical suspension of the aorta to the sternum to relieve anterior vascular compression of the trachea, used for severe tracheomalacia or vascular-ring-related airway collapse.

A congenital anomaly in which aortic arch derivatives encircle the trachea and esophagus, causing stridor, dysphagia, or recurrent respiratory symptoms; double aortic arch is the most common symptomatic type.

Acute infection of the middle ear with otalgia, fever, and bulging or erythematous tympanic membrane; treatment decisions in children depend on age, laterality, severity, and duration of symptoms.

Fluid in the middle ear without signs of acute infection, often persisting after acute otitis media; chronic bilateral effusion can cause conductive hearing loss and speech delay, prompting consideration of ventilation tubes.

A small tube placed through the tympanic membrane to ventilate the middle ear, used for recurrent acute otitis media or chronic effusion with hearing loss; complications include otorrhea, tube extrusion, and persistent perforation.

An expanding keratinizing epithelial cyst in the middle ear or mastoid that erodes bone and can cause hearing loss, facial nerve injury, or intracranial complications; treatment is surgical removal.

Mastoid surgery in which the posterior canal wall is removed to exteriorize disease, often used for extensive or recurrent cholesteatoma; creates a cavity requiring lifelong water precautions and cleaning.

Hearing impairment present at birth, classified as sensorineural, conductive, or mixed, and as syndromic or nonsyndromic; early identification through newborn screening enables timely amplification or cochlear implantation for language development.

An electrophysiologic test recording neural responses to sound from the auditory nerve and brainstem, used to estimate hearing thresholds in infants and children who cannot cooperate with behavioral audiometry.

A surgically implanted device that converts sound into electrical stimulation of the auditory nerve, indicated for children with severe-to-profound sensorineural hearing loss who receive limited benefit from hearing aids.

A benign tumor of Schwann cells on the vestibular division of the eighth cranial nerve, rare in children but associated with neurofibromatosis type 2; causes unilateral hearing loss, tinnitus, and imbalance.

A congenital remnant of the branchial apparatus presenting as a lateral neck cyst, sinus, or fistula, most commonly from the second cleft; definitive treatment is complete surgical excision to prevent recurrence and infection.

A midline neck cyst arising from persistent thyroglossal duct tissue, typically moving with tongue protrusion; treatment is Sistrunk procedure, which includes the central hyoid bone and duct tract to the foramen cecum.

A macrocystic lymphatic malformation, usually in the posterior triangle of the neck, present at birth or early infancy; large lesions can obstruct the airway and are managed with sclerotherapy or surgical resection.

A benign vascular tumor that appears shortly after birth, proliferates over months, then involutes; airway involvement can cause stridor, and problematic lesions may require beta-blocker therapy or surgery.

A mucocele arising from the sublingual gland or floor of mouth, appearing as a bluish swelling; plunging ranulas extend into the neck and require gland removal rather than simple cyst excision.

Persistent head tilt and rotation, in infants often due to sternocleidomastoid fibrosis or a mass; congenital muscular torticollis is managed with stretching, while persistent or atypical cases warrant evaluation for other causes.

A persistent epithelialized tract between the trachea and skin after tracheostomy tube removal, which may fail to close and require surgical repair, especially in children with prolonged cannulation.

Congenital underdevelopment of the external ear, ranging from mild deformity to anotia, often with external canal atresia and conductive hearing loss; reconstruction options include autologous rib cartilage or prosthetic ear.

Congenital absence or closure of the external auditory canal, usually with malformation of the middle ear and conductive hearing loss; management prioritizes hearing rehabilitation, with canalplasty reserved for selected cases.

Difficulty swallowing with passage of food or secretions below the vocal folds, causing cough, choking, or silent aspiration; in children it may result from neurologic, anatomic, or laryngeal causes and requires instrumental assessment.

Inadequate closure of the velopharyngeal port during speech, producing hypernasality and nasal air escape; causes include cleft palate, adenoidectomy, and neuromuscular disorders, with treatment by speech therapy or surgery.

Enlargement of the adenoids and tonsils that can obstruct the upper airway, causing snoring, obstructive sleep apnea, mouth breathing, and, after adenoidectomy, velopharyngeal insufficiency; tonsillectomy and adenoidectomy are common treatments.

Repetitive upper airway obstruction during sleep with disrupted ventilation and sleep architecture, common in children with adenotonsillar hypertrophy; first-line surgical treatment is adenotonsillectomy in appropriately selected patients.