Aetiology of stridor in Malaysian children

Abstract

Eighty-five children who presented with stridor were reviewed in order to determine the aetiology of stridor in these cases. Congenital causes accounted for 57.6% of cases. Laryngomalacia was the commonest congenital abnormality (77.5%). Other common causes of stridor were a foreign body in the airway (acquired) and laryngotracheobronchitis (33.3%) (infective). Tracheostomized children are a problem in developing countries, requiring prolonged hospitalization. We overcome this problem by teaching parents how to maintain the tracheostomy tube at home.

Severe upper airway obstruction in the tropics requiring intensive care

“…The causes of upper airway obstruction in children are very extensive 7,8 and require clinical expertise, skill and experience in recognizing the important circumstances and diagnoses that can rapidly progress into a life‐threatening situation. Laryngomalacia and viral croup are the most common overall causes of pediatric stridor in the tropics, 9,10 an observation that, as expected, is quite similar to the experience reported here. However, the causes and outcome of life‐threatening upper airway obstruction in children of this region remain less well determined.…”

Use of multidetector computed tomography 3D reconstructions in assessing lower tracheal–bronchial pathology and subsequent surgical interventions

“…This is different than previous studies who have concluded finding a 2:1 male predominance in airway abnormalities [14,15]. However, our result might be different because we excluded cases of laryngeal disease, which made up the majority of cases in those reviews.…”

Congenital Airway Abnormalities in Patients Requiring Hospitalization

“…7 The prevalence of laryngomalacia in our study is consistent with other series of pediatric patients with chronic stridor in the United States 2,3 and internationally. 4,5 In a series of 191 patients with congenital stridor, Holinger 2 found laryngeal abnormalities in 69%, tracheal abnormalities in 18%, and bronchial abnormalities in 6%. Laryngomalacia was the most common abnormality (41% of all congenital lesions), followed by congenital subglottic stenosis in 14% and vocal-fold paralysis in 9%.…”

“…2,3 The male preponderance of almost 2:1, of which there is no obvious explanation, is not unique to our study. 2,4,5 Stridor is the most common presenting sign of congenital airway abnormalities, with exacerbations or severity producing accessory respiratory effort, cyanosis, and apnea. 6 While a diagnosis based on the clinical history is sometimes sufficient for an isolated lesion, surgical diagnosis with flexible or rigid laryngobronchoscopy is often necessary for definitive evaluation.…”