Airway obstruction in a neonate may be associated with enlargement or displacement of the tongue.
Clinical presentation of tongue-based airway obstruction (TBAO):
(1) feeding difficulties
(2) respiratory distress
The first step in diagnosis of TBAO is to exclude other conditions:
(1) upper airway obstruction due to an obstruction related to the nares or palate
(2) airway obstruction in the larynx, trachea or bronchi
Most cases of TBAO will be due to Pierre Robin sequence (PRS), which involves micrognathia and glossoptosis. PRS may occur as an isolated finding, as part of named syndrome or associated with other congenital anomalies without syndromic designation. Many neonates with PRS will have a cleft palate as well.
If there is no evidence of PRS, then other conditions of the tongue must be considered such as macroglossia, a cyst, a tumor or congenital anomaly.
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