Endoscopic findings in children with stridor.

Martins, Regina; Dias, Norimar Hernandes; Castilho, Emanuel C.; Trindade, Sergio Henrique Kiemle

doi:10.1016/s1808-8694(15)31021-1

Cited by 14 publications

(25 citation statements)

References 22 publications

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“…We observed 70% of children in our study were aged below1 year of age showing that the stridor and respiratory distress are more frequent in this age group as also reported by other authors (Table 1) similar to our study. [4][5][6][7] Stridor in very young infants is most often due to laryngomalacia, which is consistent with our study where 348 cases of infants were diagnosed with laryngomalacia. 3 Foreign bodies in the airway are another source of stridor and one study found seeds to be the most commonly aspirated object Table 2.…”

Section: Discussionsupporting

confidence: 93%

A study on paediatric stridor causes and management: case series

Selvam

Vikram

Saktheeswaran

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONStridor is one of the life threatening symptoms presenting to the Emergency Department. 1 The word stridor is derived from the Latin word "Stridulus", which means creaking, whistling or grating. Stridor is harsh, vibratory sound of variable pitch caused by partial obstruction of the respiratory passages that results in turbulent airflow through the airway. Stridor is a sign of airway obstruction, so it demands immediate attention and thorough evaluation to uncover the precise underlying cause. 2 This study on paediatric stridor is to suggest an approach to evaluate and manage the underlying cause.Aims of the study 1. To find the causes of stridor in paediatric age group of newborn -to 12 years.2. Early identification of the cause to initiate treatment of stridor. ABSTRACTBackground: Stridor is one of the life threatening symptoms presenting to the Emergency Department. Stridor is a sign of airway obstruction, so it demands immediate attention and thorough evaluation to uncover the precise underlying cause. This study on paediatric stridor is to find the causes of stridor in paediatric age group are to identify the cause to initiate treatment of stridor, suggest an approach to evaluate and manage the underlying cause. Methods: Retrospective study of series 515 cases in paediatric age group, below 12 years of age presenting with respiratory distress to the Emergency department/ENT department. The primary management was to maintain the airway in all cases. Intravenous line established intravenous fluid/antibiotics /steroids/racemic adrenaline, followed by history of the respiratory distress from the parents/ caretakers. Then according to the provisional diagnosis evaluation is done by radiological investigation/ endoscopy. Results: Laryngomalacia was the most common cause of infant stridor in less than one year of age in 348 cases, while Foreign body aspiration is the most common cause of stridor in age group one to 12 years in 122 cases. 358 cases (69%) were treated conservatively and cause related management was done in 157 (31%). Endoscopy and imaging offers the best methods in evaluating and treatment of pediatric stridor. Conclusions:The management of stridor in pediatric age group is a team work of ENT surgeons, Pediatrician, Pediatric surgeons, anaesthetist. The airway maintenance is the main management followed by ENT examination, evaluation by imaging, endoscopy and treatment of the cause. We follow the airway management algorithm in order to evaluate the child for diagnosis of the cause for treatment and successful outcomes of stridulous pediatric patients.

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Section: Discussionsupporting

confidence: 93%

A study on paediatric stridor causes and management: case series

Selvam

Vikram

Saktheeswaran

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

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“…A regressão lenta dos sintomas respirató-rios é esperada, devido à pneumopatia pré-existente ou à traqueomálacia remanescente. Sintomas respiratórios ou gastrintestinais residuais ocorrem em 13% das crianças e a mortalidade no pós-operatório imediato é de 3,3% (16) . A cirurgia de correção do anel vascular associado à compressão traqueal tem uma mortalidade maior do que a correção do anel sem sintomas respiratórios obstrutivos (13) .…”

Section: Referências Bibliográficasunclassified

Estridor na sala de parto

Rangel

Pegorer

Vilela

2010

Rev. paul. pediatr.

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RESUMOObjetivo: Ressaltar a importância do estridor por anel vascular em recém-nascidos.Descrição do caso: Caso 1: recém-nascido a termo do sexo feminino, com história prévia de poli-hidrâmnio, apresentou estridor na sala de parto e necessidade de intubação orotraqueal com parâmetros ventilatórios moderados. Trouxe melhora do quadro respiratório após a inserçào de cânula traqueal além do habitual, o que motivou a investigação de compressão traqueal extrínseca. Realizado diagnóstico de duplo arco aórtico, seguido de cirurgia corretiva com boa evolução. Caso 2: menina de sete meses com estridor desde o nascimento e diagnóstico prévio de laringomalácia, com diversas internações anteriores por doenças respiratórias. Na última internação, houve melhora dos sintomas após a intubação seletiva do brônquio principal direito, sugerindo compressão extrín-seca da traqueia. Após a confirmação do diagnóstico de anel vascular, foi submetida à correção cirúrgica, porém evoluiu a óbito.Comentários: O anel vascular não é a principal causa de estridor em recém-nascidos, mas deve ser considerado no diagnóstico diferencial. O baixo índice de suspeição dessa alteração leva a atrasos no tratamento e, como consequência, aumenta o risco de traqueomalácia e dismotilidade esofágica mesmo após a correção cirúrgica.Palavras-chave: recém-nascido; sons respiratórios; estenose traqueal; aorta torácica. ABSTRACT Objective:To underline the importance of vascular rings causing stridor in newborns infants.Case description: Case 1: term female newborn infant with prenatal history of polyhydramnios that presented stridor in the delivery room. She was treated with endotracheal intubation and moderate ventilator settings. She improved her respiratory distress after the insertion of the endotracheal tube deeper than usual. This fact prompted the investigation of extrinsic tracheal compression. A double aortic arch was diagnosed, which had satisfactory surgical outcome. Case 2: a seven-month old girl with stridor since birth and previous diagnosis of laryngomalacia had several hospital admissions due to respiratory distress. In her last hospital stay, she improved after a selective intubation of the right main bronchus, suggesting the presence of extrinsic tracheal compression. After the diagnosis of a vascular ring, she was submitted to the surgical correction, but she died soon after surgery.Comments: Vascular rings are not the main cause of upper airway obstruction in newborn infants but they should be considered in the differencial diagnosis. The low index of suspicion delays diagnosis and treatment and increases the risk of tracheomalacia and esophageal dysmotility, even after surgical repair.

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“…Although stridor may be the result of a relatively benign process, it may also be the first sign of a serious and even life-threatening disorder [1]. Congenital airway anomalies are the most frequent causes of stridor in newborns and infants, of which laryngomalacia is the main etiologic abnormality [2][3][4][5][6]. Although laryngomalacia is a self-limiting condition which may only occasionally need any intervention [5], other common causes of airway obstruction should be excluded as these may be life threatening and require early surgical intervention [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Other relatively common congenital malformations of the larynx and trachea that cause stridor include tracheomalacia, atresia, laryngeal webs, cysts, subglottic stenosis, laryngeal clefts, haemangiomas, laryngocele and vocal cord palsy [2,3,8]. Vascular rings compressing the trachea, prolonged intubation, foreign bodies and tumours are some of the acquired causes of paediatric upper airway respiratory distress [2,6].…”

Section: Introductionmentioning

confidence: 99%

“…Detailed airway endoscopy will be required in most patients, not only for diagnosis, but also to treat the condition. Flexible bronchoscopy does not require general anaesthesia and allows the examination of the nose, the pharynx, the supra and subglottic regions and laryngeal and tracheal dynamics [6]. There are few studies in literature to date, which investigate laryngeal and tracheal pathologies in childhood, aided by flexible fibreoptic bronchoscopy.…”

Section: Introductionmentioning

confidence: 99%

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