Common causes of congenital stridor in infants

Abstract

Stridor is a high-pitched respiratory sound that signals upper airway obstruction. It can be encountered by clinicians in a variety of clinical settings and requires a team-based, interdisciplinary approach. Early recognition is crucial, as the differential diagnosis can be broad, and causes range from benign to life-threatening. This article reviews the most commonly encountered causes of chronic congenital stridor in infants, focusing on the diagnostic approach, pathophysiology, clinical presentation, and management strategies.

The Prevalence of Dysphagia in Children with Laryngomalacia Pre and Postsupraglottoplasty: A Systematic Review with Meta-Analysis

“…5 In addition, stridor usually worsens with feeding, 8 supine positioning (5.8), agitation 7 and may present as a single symptom or with other symptoms, such as respiratory effort, tachypnea, and chest retraction, among others. 5,6,8 The diagnosis of LM takes into account the patient's clinical history, but it is confirmed, most of the time, with a flexible fiberoptic laryngoscopy exam, which investigates the dynamic movement of the laryngeal structures during breathing, performed with the patient awake 2,5,7,8 or under sedation in spontaneous breathing. The main findings of the examination are prolapse of supra-arytenoid tissue during inspiration, epiglottis with an omega or retroflex shape, shortened aryepiglottic folds, redundant arytenoid mucosa, poor visualization of the vocal folds, and edema of the posterior glottis region.…”

“…The main findings of the examination are prolapse of supra-arytenoid tissue during inspiration, epiglottis with an omega or retroflex shape, shortened aryepiglottic folds, redundant arytenoid mucosa, poor visualization of the vocal folds, and edema of the posterior glottis region. 2,3,[6][7][8] The symptoms of LM usually begin to appear in the 2 nd week of life, but, in most cases, they resolve spontaneously with little or no treatment until 18 to 24 months of age. 1,2,8 The spontaneous resolution of cases often requires, in addition to monitoring the patient, changes in their diet and specific treatment for gastroesophageal reflux (GER).…”

Endoscopic Preoperative Assessment, Classification of Stenosis, Decision-Making

“…The main causes of pediatric LTS can be divided into two groups, i.e., congenital and acquired. The most common causes of congenital LTS include laryngomalacia (60%), vocal fold paralysis (15-20%), subglottic stenosis (SGS) (10-15%), laryngeal webs and atresia (5%), subglottic hemangioma (1.5-3%), and others (1). On the other hand, 90% of acquired pediatric LTSs occur after post-intubation injuries.…”

Laryngeal Hamartoma Presenting as Congenital Stridor in Neonate: A Rare Entity

“…Causes of paediatric stridor can be broadly classified into congenital or acquired and acquired can be further subclassified as febrile or afebrile cause. Most common cause of congenital stridor in neonate are laryngomalacia which accounts for 60% to 70% of cases, followed by vocal cord paralysis, laryngeal web, congenital subglottic stenosis, tracheomalacia and subglottic haemangioma [1]. Laryngeal hamartoma is a rare cause of congenital stridor.…”