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]
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]
Respiratoric
- 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]
[L. a harsh, creaking sound] stridor (strī´dôr), n a peculiar, harsh, vibrating sound produced during respiration. stridor, inspiratory, n the stridor heard in inspiration through a spasmodically closed glottis. stridor, laryngeal, n a stridor resulting [medical-dictionary.thefreedictionary.com]
Table 2— Medical characteristics of patients with post-extubation stridor DISCUSSION Post-extubation stridor may occur in 2–15% of intubated patients. [erj.ersjournals.com]
Cardiovascular
- 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]
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]
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]
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]
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
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]
Prognosis
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]
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]
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]
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]
Common etiologies include inherent structural defects (such as laryngomalacia), vocal fold paralysis, acquired infectious etiologies, or extrinsic compressions. [nature.com]
Epidemiology
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]
Pathophysiology
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]
Mor N, Simonyan K, Blitzer A: Central voice production and pathophysiology of spasmodic dysphonia. [merckmanuals.com]
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]
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]
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]
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]
Prevention Adults must keep small, easily swallowed objects such as coins, beads, and hard, round candies away from young children so that they do not try to swallow them. [healthofchildren.com]