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]
Congenital laryngeal stridor is a defect that is present at birth. During fetal development, the structures in the larynx may not fully develop. [nyhq.org]
Respiratoric
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Stridor
However, dystonia in the laryngeal adductor muscles has also been reported to cause laryngeal stridor. [ncbi.nlm.nih.gov]
Cardiovascular
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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]
In more severe cases of laryngomalacia, there may be: Vomiting or spitting up food (reflux) Poor weight gain Difficulty eating Choking on food Pauses in the breathing (apnea) or turning blue (cyanosis) Chest or neck sinking in when breathing (retractions [nationwidechildrens.org]
[…] upper respiratory infection, like a cough or cold Other symptoms of more severe congenital laryngeal stridor can include: Difficulty feeding Poor weight gain Choking while feeding Apnea (pauses in breathing) Pulling in neck and chest with each breath Cyanosis [cooperhealth.org]
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]
[…] 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]
Neurologic
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Dysarthria
Muller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K, Poewe W, Litvan I: Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol 2001;58:259–264. [karger.com]
Workup
When hoarseness persists in children for more than 6 weeks, or when an acute airway obstruction does not respond to racemic epinephrine or bronchodilator therapy, careful thought should be given to the differential diagnosis, and further otolaryngology workup [consultant360.com]
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]
When a tumor is suspected, obtain an MRI or CT scan, as well as a laboratory workup to screen for an oncologic process, including complete blood count (CBC), blood smear, LDH, and inflammatory markers. [ahcmedia.com]
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]
Although not common, some babies develop severe breathing problems which need treatment. Treatment may include medicines, a hospital stay, or surgery. Treatment will depend on your baby’s symptoms, age, and general health. [stanfordchildrens.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]
Treatment and prognosis Different forms of treatment have been described for laryngeal cysts, such as aspiration, marsupialisation with laser ablation and complete excision. [radiopaedia.org]
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]
Prognosis The outcome of stridor depends on its cause. Death by suffocation may occur when a foreign object blocks the airway. Otherwise the outcome for most cases of stridor is good to excellent, depending on the cause. [healthofchildren.com]
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]
The estimated incidence is 4.3 cases per million; the estimated cost of care in the United States ranges from 40 million to 123 million annually. 3,4 Etiology. [consultant360.com]
Also, viral upper respiratory infection causing acute edema frequently is the first presentation of another underlying etiology. Thus, conduct a thorough history and remember that more than one etiology may be present in any given patient. Croup. [ahcmedia.com]
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]
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]
JUVENILE LARYNGEAL PAPILLOMATOSIS Epidemiology. Juvenile laryngeal papillomatosis--also known as juvenile respiratory papillomatosis or recurrent respiratory papillomatosis--is relatively uncommon. [consultant360.com]
Biphasic stridor suggests subglottic or glottic obstruction. [ 1 ] Epidemiology The detailed epidemiology of stridor depends on the cause, but it is worth noting the following patterns of disease: Stridor is common in younger children with smaller airways [patient.info]
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]
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]
Amongst the various mechanisms claimed in pathophysiology of respiratory failure caused by hypothyroidism the reduction in central respiratory drive, respiratory muscle weakness and sleep related breathing disorders are the crucial one [ 2 ]. [casereports.in]
[…] 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
Otherwise, tracheotomy should be avoided as much as possible to prevent dissemination of the papillomas to the rest of the respiratory tract. Prevention. [consultant360.com]
Causes and symptoms During childhood, stridor is usually caused by infection of the cartilage flap (epiglottis) that covers the opening of the windpipe to prevent choking during swallowing. [medical-dictionary.thefreedictionary.com]
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]
Avoiding vocal cord stimulation when the patient is lightly anesthetized can usually prevent laryngospasm. [airwayjedi.com]