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Laryngeal Stridor

Laryngismus


Presentation

  • We report a 47-year-old man who presented with an 8-year history of slowly progressive dyspnea and episodic stridor.[ncbi.nlm.nih.gov]
  • Abstract The authors present the case of an infant with laryngeal stridor, apneic spells, and an open lumbar myelomeningocele; granulomatous vernix caseosa meningitis was found at autopsy.[ncbi.nlm.nih.gov]
  • A living-unrelated renal transplant recipient presented with a history of fever with chills and rigors for 3 days. Clinically, the cause of the fever could not be localized.[ncbi.nlm.nih.gov]
  • A case of a child with a biotinidase deficiency who had a laryngeal stridor as a leading symptom is presented. This rare disease is distressing for diagnosis but easily treatable, if recognized.[ncbi.nlm.nih.gov]
  • Congenital laryngeal stridor results from a congenital (present at birth) abnormality of the larynx (voice box). Stridor is a high-pitched sound that is best heard when the child breathes in.[entcolumbia.org]
Stridor
  • However, dystonia in the laryngeal adductor muscles has also been reported to cause laryngeal stridor.[ncbi.nlm.nih.gov]
  • The suggest that chemical meningitis which also involved the cranial nerves might be held partly responsible for the laryngeal stridor.[ncbi.nlm.nih.gov]
  • Emergency tracheostomy may be life-saving in cases of acute stridor. Cricoarytenoid inflammation and airway compromise may respond to local or systemic corticosteroid therapy.[ncbi.nlm.nih.gov]
  • Abstract A three and a half-year-old boy developed stridor after insertion of grommets for bilateral secretory otitis media. Despite treatment with steroids systemically and locally, antibiotics and an antihistamine, the stridor worsened.[ncbi.nlm.nih.gov]
  • Two patients with laryngeal stridor secondary to myasthenia gravis are reported. The cause of bilateral abductor weakness in myasthenia is discussed; anticipation of the stridor in myasthenic patients is highlighted.[ncbi.nlm.nih.gov]
Cyanosis
  • Other symptoms may include: difficulty feeding poor weight gain choking while feeding apnea (pauses in breathing) pulling in neck and chest with each breath cyanosis (blue spells) gastroesophageal reflux (spitting, vomiting and regurgitation) Inhalation[childrenshospital.org]
  • […] congenital aetiology History of foreign body aspiration Hoarseness of voice in the past Clinical examination: Upper airway examination for any visible obstructive lesion Examination of cardiovascular system To note signs of respiratory distress and cyanosis[specialist-ent.com]
  • Beware of signs of respiratory distress, cyanosis or drooling Respiratory examination from Oxford Medical Videos Management of stridor Stridor is an emergency Manage with ABCDE approach Call an anaesthetist early Get the patient to a safe place and get[oxfordmedicaleducation.com]
  • Examination When examining the infant check for: cyanosis degree of respiratory distress nature of stridor ability to feed choanal patency jaw and tongue size auscultation (transmission of breath sounds).[www2.health.vic.gov.au]
  • Pediatric Laryngeal Disease Supraglottitis (epiglottitis) is a life threatening condition seen usually in children and characterized by the abrupt onset of fever, drooling, cyanosis, airway obstruction and dysphagia.[docraza.tripod.com]
Arthritis
  • Stridor in patients with rheumatoid arthritis is typically due to arthritis of the cricoarytenoid joints leading to fixation of the vocal cords in a midline position. Cricoarytenoid joint arthritis may be acute, chronic, or acute-on-chronic.[ncbi.nlm.nih.gov]
Meningism
  • The suggest that chemical meningitis which also involved the cranial nerves might be held partly responsible for the laryngeal stridor.[ncbi.nlm.nih.gov]

Workup

  • The age of onset, patient history, tonal quality, and relation to the timing of the respiratory cycle is critical to the workup of a patient with stridor.[medicine.uiowa.edu]

Treatment

  • For the treatment of these symptoms relief of the increase in intracranial pressure, relief of the pressure difference between intracranial and intraspinal compartments, and selection of a shunt system with a proper flow rate are important.[ncbi.nlm.nih.gov]
  • Despite treatment with steroids systemically and locally, antibiotics and an antihistamine, the stridor worsened.[ncbi.nlm.nih.gov]
  • Treatment for stridor decreased the relative risk from 2.998 to 0.147. Laryngeal stridor is a common and early clinical symptom in MSA. Early treatment for stridor is advisable to reduce mortality. Copyright 2003 S. Karger AG, Basel[ncbi.nlm.nih.gov]
  • We report three cases from the Rheumatology Department of University College Hospital, London and review the literature on the prevalence, clinical presentation, histopathological features and treatment of laryngeal involvement in rheumatoid arthritis[ncbi.nlm.nih.gov]
  • Our team provides the most advanced testing and surgical treatments available for this condition.[childrenshospital.org]

Prognosis

  • Kurisaki H: Prognosis of multiple system atrophy – survival time with or without tracheostomy (in Japanese). Rinsho Shinkeigaku 1999;39:503–507.[karger.com]
  • Prognosis Most have uneventful course and improve in a few days Recurrence can occur in some instances Suggests airway hyperreactivity 12. Supraglottitis 13. TRUE MEDICAL EMERGENCY![slideshare.net]
  • An improved understanding of this breathing disorder is essential since nocturnal stridor carries a poor prognosis (an increased risk of sudden death).[journals.plos.org]

Etiology

  • Despite reports of this disorder dating back to the mid-19th century, specific etiology and pathogenesis remain nebulous.[ncbi.nlm.nih.gov]
  • Etiology of stridor in the neonate, infant and child. Ann Otol Rhinol Laryngol. 1980[medicine.uiowa.edu]
  • This article reviews the etiology of stridor in children and suggests an approach to evaluating and managing the problem. Etiology and Clinical Manifestations Causes of stridor in children according to the site of obstruction are listed in Table 1.[aafp.org]
  • Respiratory Papillomatosis  Post Intubation Glottic and Subglottic Lesions  Congenital Glottic and Subglottic Stenosis  Extra-Esophageal (Gastroesophageal) Reflux Disease/Eosinophilic Esophagitis  Foreign Body  Tracheal  Esophageal Laryngeal Stridor: Etiology[slideshare.net]
  • "Etiology of stridor in the neonate, infant and child". Ann. Otol. Rhinol. Laryngol. 89 (5 Pt 1): 397–400. PMID 7436240. Wittekamp, Bastiaan HJ.[en.wikipedia.org]

Epidemiology

  • Hirayama K, Takayanagi T, Nakamura R, Yanagisawa N, Hattori T, Kita K, Yanagimoto S, Fujita M, Nagaoka M, Satomura Y, Sobue I, Iizuka R, Toyokura Y, Satoyoshi E: Spinocerebellar degenerations in Japan: A nationwide epidemiological and clinical study.[karger.com]
  • BRLNP is rare, occurring in approx. 0.2% of thyroidectomies for benign thyroid affections. (2) Epidemiological data on late BRLNP after thyroidectomy is spares.[signavitae.com]
  • Bronchitis, Laryngotracheitis, Laryngotracheobronchitis, Laryngotracheobronchopneumonitis, Spasmodic Croup See Also Croup Score Dexamethasone in Croup Stridor Epiglottitis Bacterial Tracheitis History Word "Croup" derived from Scottish for raven's "croak" Epidemiology[fpnotebook.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiologic der stenosen von kehlkopf und trachea. Archiv f r Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde , Vol. 199, Issue. 1, p. 65. CrossRef Google Scholar Martin, J. A. M. 1967.[cambridge.org]
  • Tracheomalacia Pathophysiology – expiratory collapse of the intrathoracic airway, due to defective cartilaginous support.[pedclerk.bsd.uchicago.edu]
  • Pathophysiology: Stridor is caused by restriction of airflow through the upper airways. As the radius of the airway deceases by a factor of 1, the area of the airway decreases by a power of 4.[medicine.uiowa.edu]
  • […] year round sporadically Affects ages under 6 years (rarely up to 8 to 12 years) Most common cause of Stridor in children 6 months to 3 years of age Typical age 6 months to 36 months of age (peaks between 12 and 24 months) Rare before 3 months of age Pathophysiology[fpnotebook.com]

Prevention

  • Corticosteroids to prevent postextubation upper airway obstruction: the evidence mounts. Crit Care. 2007;11(4):156. PMC2206510.[lifeinthefastlane.com]
  • You can also relieve GERD and LPR, and help prevent laryngospasm, by following these lifestyle tips: Avoid common heartburn triggers, such as fruit and fruit juices, caffeine, fatty foods, and peppermint.[webmd.com]
  • On the other hand, sometimes CPap will help prevent acid reflux, by removing the suction effect of the laryngomalacia.[notjustaboutwee.com]
  • Airway obstruction, whether caused by croup or another condition, is an emergency situation that must be investigated fully and treated promptly to prevent a detrimental outcome.[americannursetoday.com]
  • Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. Anesthesiology 1992 ; 77 : 245 –251. Epstein SK.[erj.ersjournals.com]

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