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]

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]

• Collapse

  Schwartz,3 who gave an excellent historical survey, advocated replacing "congenital laryngeal stridor" by "inspiratory laryngeal collapse."Since this noisy breathing is merely a symptom, the underlying pathological conditions are endlessly varied. [jamanetwork.com]

  In terms of respiratory disease, softening of the airway leads to narrowing or collapse during part of the respiratory cycle. Tracheomalacia Pathophysiology – expiratory collapse of the intrathoracic airway, due to defective cartilaginous support. [pedclerk.bsd.uchicago.edu]

  As a result, there is a weakness in these structures at birth, causing them to collapse during breathing. In children, congenital laryngeal stridor is the most common cause of chronic stridor. [nyhq.org]

  For example, in laryngomalacia, a weakness of the laryngeal structures causes them to collapse during breathing. In children, laryngomalacia is the most common cause of stridor. This particular issue resolves by 12 to 18 months, usually on its own. [entcolumbia.org]

• Weight Gain

  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]

  Your child is not gaining weight. If you have questions or concerns, be sure to ask your child’s doctor or nurse. Laryngomalacia (PDF) HH-I-332 Revised 3/15 Copyright 2011, Nationwide Children’s Hospital [nationwidechildrens.org]

  gain Choking while feeding Apnea (pauses in breathing) Pulling in neck and chest with each breath Cyanosis (a bluish cast to the skin, usually caused by low oxygen levels) Gastroesophageal reflux (spitting, vomiting, and regurgitation) Inhalation of [cooperhealth.org]

  In cases where significant obstruction or lack of weight gain is present, surgical correction or supraglottoplasty may be considered if the clinician has observed tight mucosal bands holding the epiglottis close to the true vocal cords or redundant mucosa [emedicine.medscape.com]

  Symptoms of laryngomalacia include: inspiratory stridor difficulty feeding choking while feeding acid reflux poor weight gain stopping breathing bluish skin color In 90 percent of cases, laryngomalacia gets better without treatment by the time the child [medicalnewstoday.com]

• Developmental Delay

  Severe laryngomalacia also has continual stridor and increased work of breathing, accompanied by respiratory failure requiring oxygen or airway support, developmental delay and/or failure to thrive. [pedclerk.bsd.uchicago.edu]

  Issues to note: It results from prolapse of the epiglottis/arytenoids/aryepiglottic folds during inspiration due to a developmental delay in maturation of these supporting structures of the larynx. [www2.health.vic.gov.au]

• Trisomy 21

  A retrospective study also revealed an increase in the prevalence of stridor from multiple causes in patients with trisomy 21. 10 Pathophysiology Stridor may result from any obstruction that impedes the flow of air through the airway. [ahcmedia.com]

• Stridor

  However, dystonia in the laryngeal adductor muscles has also been reported to cause laryngeal stridor. [ncbi.nlm.nih.gov]

  Other characteristics of the stridor may include: The stridor changes with activity. The stridor is usually less noisy when the child is laying on his/her stomach. The stridor gets worse if the infant has an upper respiratory infection. [childrensnational.org]

  Stridor is a high-pitched sound that is heard best when the child breathes in (inspiration). What causes congenital laryngeal stridor? Congenital laryngeal stridor is a defect that is present at birth. [medcentral.org]

  In children, congenital laryngeal stridor is the most common cause of chronic stridor. What are the symptoms of congenital laryngeal stridor? The major symptom of this disorder is the stridor that is heard as the infant breathes. [stanfordchildrens.org]

• Respiratory Distress

  Abstract Twelve patients with Chiari II malformation developed laryngeal stridor and respiratory distress. [ncbi.nlm.nih.gov]

  Key words: bilateral recurrent laryngeal nerve palsy, respiratory distress, thyroidectomy, goiter, postoperative complication. [signavitae.com]

  Important associated symptoms in all cases include cough, pain, drooling, respiratory distress, cyanosis, and difficulty feeding. [merckmanuals.com]

  After trauma during birth (usually traction) or at intubation it is usually unilateral with a hoarse cry and little or no respiratory distress. [www2.health.vic.gov.au]

  Presentation Progression of illness more rapid than croup Cough usually absent, high fever Drooling, apprehension, dysphagia, respiratory distress, and toxicity Resist lying down Classic “tripoding” posture Sits upright with arms forward in front [slideshare.net]

• Inspiratory Stridor

  Bilateral vocal-cord paralysis produces a high-pitched inspiratory stridor. (Stridor doesn’t occur in unilateral vocal-cord paralysis.) Congenital subglottic stenosis causes stridor that’s commonly biphasic or inspiratory. [americannursetoday.com]

  Inspiratory Stridor Typically caused by obstruction at or above the level of the vocal cords Expiratory Stridor Usually localized to the more distal tracheobronchial tree Biphasic Stridor Usually caused by obstructions at the true vocal cords 3. [slideshare.net]

  Chronic stridor Laryngomalacia is the most common cause of inspiratory stridor in the neonatal period and early infancy and accounts for as many as 75% of all cases of stridor. [6] Stridor may be exacerbated by crying or feeding. [emedicine.medscape.com]

  Physical examination at admission showed inspiratory stridor and bronchospasm, but was otherwise without pathological findings. The chest X-ray was normal. [signavitae.com]

  Inspiratory stridor is more likely to be caused by extrathorasic obstruction to air flow while expiratory stridor is more likely to occur with intrathorasic pathology. [medicine.uiowa.edu]

• Snoring

  Nocturnal stridor and snoring were analyzed with the Multi-Dimensional Voice Program. Nocturnal stridor was recorded in 22 patients and snoring in 18 patients using the PSG. [journals.plos.org]

  A 56-year-old man presented with abnormal breathing sound different from snoring during sleep noticed by his bed partner. He is unaware of his nocturnal stridor. Polysomnography showed obstructive sleep apnea and laryngeal stridor. [e-jsm.org]

  Kavey NB, Whyte J, Blitzer A, Gidro-Frank S: Sleep-related laryngeal obstruction presenting as snoring or sleep apnea. Laryngoscope 1989;99:851–854. [karger.com]

  He's 7 months old now and still snores at times but he is so much better than he was. We got to the point where me and dp were sleeping with ear plugs in!! We could hear ds snoring when he was upstairs and we were downstairs watching tv! [mumsnet.com]

• Abnormal Breathing

  A 56-year-old man presented with abnormal breathing sound different from snoring during sleep noticed by his bed partner. He is unaware of his nocturnal stridor. Polysomnography showed obstructive sleep apnea and laryngeal stridor. [e-jsm.org]

  […] of the Chest Physical abnormalities of the chest may effect breathing or they may be caused by lung disease. [reocities.com]

• 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]

  Blue is generally associated with the term cyanosis. It should be noted that cyanosis is a late and unreliable sign, unless accompanied by other signs, symptoms and tests. Examine the head, neck and note signs of central cyanosis. [reocities.com]

  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]

  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]

  Bilateral may present with apnoea or cyanosis during feeding. It can be diagnosed by an inability to pass a nasal catheter. [patient.info]

• Prolapse

  Typically, laryngoscopy reveals flaccid supraglottic structures which tend to prolapse medially toward the glottis during inspiration. [ncbi.nlm.nih.gov]

  Presentation Staccato inspiratory stridor Worse with exertion, feeding, crying Noisy breathing generally begins at about 2-4 weeks of age  Endoscopic appearance Omega epiglottis Foreshortenend aryepiglottic folds Cuneiform prolapse 6. [slideshare.net]

  Neuromuscular immaturity may contribute to the prolapse of the arytenoids observed in laryngomalacia; however; there is no increase in the incidence of laryngomalacia in premature infants with classic hypotonicity (1). [hawaii.edu]

  Type 1 : prolapse of mucosa onto arytenoids Type 2 : foreshortened aryepiglottic folds Type 3 : posterior displacement of the epiglottis Clinical presentation & course – Inspiratory stridor, usually presents during the first 2 weeks of life, worsens up [pedclerk.bsd.uchicago.edu]

  Issues to note: It results from prolapse of the epiglottis/arytenoids/aryepiglottic folds during inspiration due to a developmental delay in maturation of these supporting structures of the larynx. [www2.health.vic.gov.au]

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]

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]

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]

Treatment In most cases, this is a harmless condition that goes away on its own without treatment. It usually improves by the time the child reaches 18 months of age. [nationwidechildrens.org]

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]

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 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]

Kurisaki H: Prognosis of multiple system atrophy – survival time with or without tracheostomy (in Japanese). Rinsho Shinkeigaku 1999;39:503–507. [karger.com]

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]

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]

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]

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]

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]

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]

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]

Mor N, Simonyan K, Blitzer A: Central voice production and pathophysiology of spasmodic dysphonia. [merckmanuals.com]

Tracheomalacia Pathophysiology – expiratory collapse of the intrathoracic airway, due to defective cartilaginous support. [pedclerk.bsd.uchicago.edu]

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]

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]

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]

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]

Prevention Hib vaccine Getting the Haemophilus influenzae type b (Hib) vaccine prevents epiglottitis caused by Hib. In the United States, children usually receive the vaccine in three or four doses: At 2 months. At 4 months. [mayoclinic.org]

Corticosteroids to prevent postextubation upper airway obstruction: the evidence mounts. Crit Care. 2007;11(4):156. PMC2206510. [lifeinthefastlane.com]

Avoiding vocal cord stimulation when the patient is lightly anesthetized can usually prevent laryngospasm. [airwayjedi.com]