Who'sinCHARGE?Multidisciplinar y management ofpatients withCHARGE association

Clinical experience of50patients withthe CHARGEassociation isreviewed andproblemswithmanagement ofchildren bornwith multiple system involvement ishighlighted. It wasfoundthattheoutlook forsurvival was poorifmorethanoneofthefollowing three features was present: cyanotic cardiac lesions, bilateral posterior choanal atresia, or tracheo-oesophageal fistula. Mortality was largely duenottothestructural heart defects orchoanal abnormalities, butreflected underlying pharyngeal andlaryngeal incoordination, whichresulted inaspiration ofsecretions. Outcome islikely tobeimproved ifcollaboration between specialist surgical teams allows necessary procedures tobeperformed using theminimumnumberofanaesthetics. Examination ofboththeshort andlongterm management ofthesechildren hasstressed the importance of a multidisciplinar y approach totheir care.