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Midfacial Hypoplasia Associated With Long-term Intubation for Bronchopulmonary Dysplasia
Avi Rotschild, MD;
Penelope J. Dison, MB, MRCP(UK);
David Chitayat, MD;
Alfonso Solimano, MD, FRCP(C)
Am J Dis Child. 1990;144(12):1302-1306.
Abstract
• Six preterm infants with bronchopulmonary dysplasia were nasotracheally intubated for 68 to 243 days. Gestational age at birth ranged from 24 to 35 weeks. Endotracheal tube size was changed to account for growth and varied from 2.5 to 4.0 mm. These infants developed features of midfacial hypoplasia, namely, depressed nasal bridge, small-tipped nose, long philtrum, underdeveloped malar areas, and carplike mouth. These features have not been associated with long-term intubation in premature infants. We suggest that features of prolonged nasotracheal intubation, such as direct compression by the tube and the method of tube fixation, decreased air flow through the developing nares and sinuses and reduced faciomuscular activity, resulting in the observed midfacial hypoplasia. The degree to which growth corrects these deformations is unknown.
(AJDC. 1990;144:1302-1306)
Author Affiliations
From the Departments of Pediatrics (Drs Rotschild, Solimano, and Dison) and Medical Genetics (Dr Chitayat), Division of Neonatology, University of British Columbia, British Columbia's Children's Hospital, and Grace Hospital, Vancouver.
Footnotes
Accepted for publication June 27, 1990.
Presented in part as a poster exhibit at the meeting of the Society for Pediatric Research, Washington, DC, May 1, 1989, and the 14th Annual Conference on Neonatal/Perinatal Medicine, Section on Perinatal Pediatrics, District VIII of the American Academy of Pediatricians, Anchorage, Alaska, May 25-27, 1989.
Reprint requests to British Columbia's Children's Hospital, Room 1N1, 4480 Oak St, Vancouver, British Columbia, Canada V6H 3V4 (Dr Solimano).
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