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Congenital malposition of trachea — Clinical Guidelines

Overview

Congenital malposition of the trachea is not directly addressed in the provided abstracts. However, the abstracts focus on related congenital eyelid malpositions, such as congenital eyelid imbrication syndrome (CEIS) and congenital tarsal kink syndrome, which involve abnormal positioning of eyelid structures rather than the trachea.

Diagnosis

Key Diagnostic Criteria: Bilateral upper eyelids overriding lower eyelids, especially during sleep 1 3 5.

Physical Examination: Canthal tendon laxity and hyperemia of the tarsal conjunctiva 1 3.

Clinical Presentation: Spontaneous resolution within days to weeks without complications 1 3 5.

Management

First-Line Treatment: Conservative management with lubricant ointment for CEIS 1.

Surgical Intervention: Absorbable everting sutures via a posterior approach for congenital tarsal kink syndrome 2.

Conservative Approach: Gradual resolution without specific treatment noted in some cases 5.

Special Populations

Pediatrics: Neonates with CEIS and congenital tarsal kink syndrome show spontaneous resolution with conservative or minimally invasive treatments 1 2 3 5.

Key Recommendations

Monitor and Apply Lubricants: For congenital eyelid imbrication syndrome, initiate conservative management with lubricant ointment to prevent corneal irritation 1 (Evidence: Moderate).

Consider Surgical Correction: For congenital tarsal kink syndrome leading to trichiasis and keratitis, employ absorbable everting sutures via a posterior approach for effective correction 2 (Evidence: Weak).

Expect Spontaneous Resolution: In cases of congenital eyelid malpositions like CEIS, expect resolution within a week without residual sequelae 3 5 (Evidence: Expert opinion).

References

1 Ramos-Dávila EM, Ruiz-Lozano RE, Lam-Franco L, Ferran CG, Paez-Garza JH. Congenital eyelid imbrication syndrome in a Hispanic newborn: case report and review of the literature. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 2023. link 2 Vahdani K, Konstantinidis A, Thaller VT. A Simple New Technique for Treatment of Tarsal Kink Syndrome. Ophthalmic plastic and reconstructive surgery 2017. link 3 Chandravanshi SL, Rathore MK, Tirkey ER. Congenital combined eyelid imbrication and floppy eyelid syndrome: case report and review of literature. Indian journal of ophthalmology 2013. link 4 Sharpe EL. Repositioning techniques for malpositioned neonatal peripherally inserted central catheters. Advances in neonatal care : official journal of the National Association of Neonatal Nurses 2010. link 5 Rumelt S, Kassif Y, Rehany U. Congenital eyelid imbrication syndrome. American journal of ophthalmology 2004. link 6 To WW, Li IC. Occipital posterior and occipital transverse positions: reappraisal of the obstetric risks. The Australian & New Zealand journal of obstetrics & gynaecology 2000. link 7 Alpar JJ. Eversion of upper eyelids. Annals of ophthalmology 1977. link

Congenital malposition of trachea