Management of Stridor in Paediatric Population- Our Experience

Abstract

BACKGROUNDStridor is a common presentation in paediatric ENT OPDs. (1) There can be numerous causes of stridor in this age group-congenital and acquired. (2) There are various methods available for diagnosis of such cases-radiological, rigid laryngotracheobronchoscopy and fibreoptic laryngoscopy. (3) The approach to such a case and its subsequent management varies from case to case. (4) Treatment strategy for each possible cause varies. There are very few case series in Indian population reporting such cases. In our tertiary care centre, we come across many cases with stridor. Their subsequent evaluation leads us to diagnosis. At times, upper airway evaluation is normal. The management then depends on specific aetiology. We are describing our case series comprising 15 patients with various diagnosis and subsequent management. METHODSThis is a case series comprising 15 patients. This is a prospective study carried out at our tertiary care centre. The variety of cases included laryngomalacia, retropharyngeal abscess and subglottic stenosis which were managed as per existing guidelines. RESULTSThe outcomes of our series were quite promising with 93.33 % children successfully decannulated. CONCLUSIONSThe management of a child with stridor is a challenge for the treating team. We should keep in mind that every paediatric case of stridor does not imply an underlying pathology. A systematic approach and keeping all the possible differential diagnoses in mind are the most important steps in achieving optimum results.

Etiology, Clinical Profile, Evaluation, and Management of Stridor in Children

“…Thus, supraglottoplasty can be considered in severe cases and different series of laryngomalacia reported its success rate from 80%–100% [ 13 ]. In a recent study from Army Hospital Research and Referral, New Delhi; from a series of 15 cases of stridor, 4 cases were of laryngomalacia and all 4 underwent supraglottoplasty [ 14 ]. However, it is from a surgical unit, so only cases requiring surgery might be admitted.…”