© Borgis - New Medicine 4/2013, s. 120-122
Monika Jabłońska-Jesionowska, *Lidia Zawadzka-Głos
Congenital respiratory stridor in children
Department of Pediatric Otolaryngology, Medical University of Warsaw, Poland
Head of Department: Lidia Zawadzka-Głos, MD, PhD
Introduction. Respiratory stridor is a clinical symptom. This is the sound arised when air flows through narrowed airways and always showsimpairmentof airways patency. The narrowing of the airways may result from the pathology in their interior or from outside pressure.
Aim. The aim of this study is to analyze the congenital respiratory stridor in children.
Material and methods. In the Department of Pediatric Otolaryngology, Medical University of Warsaw in the period 2010-2013, 133 children were hospitalized because of an congenital respiratory stridor. During the clinical investigation following tests were made: chest X-ray, larynx ultrasound andcranial ultrasound, barium esophagography, ECG and echocardiography, laryngotracheoscopy, chest angio-CT, neurological and cardiological consultation.
Results. There were found: 3 cases of laryngeal cleft in I degree, haemangioma of the larynx in 5 cases, congenital paralysis of the vocal foldsin 4, laryngeal papillomatosis in 1, congenital stenosis of the cricoid cartilage in 6, laryngeal cyst in 5, vascular ring in 25, laryngomalacia in 85 cases. The clinical symptoms presented by children were: respiratory stridor, dyspnea during exercise, silent cry, sleepapnea, cyanosis, dysphagia, recurrentairway infections. The age of diagnosed children ranged from 1 week to 16 years.
Conclusions. 1. The laryngomalacia is not only one casue of congenital respiratory stridor. 2. Every congenital respiratory stridor is an indication for interdisciplinary investigation. 3. The standard procedure in the investigation of congenital stridor is endoscopy of larynx, trachea and bronchi. 4. Many disorders, which causes congenital respiratory stridor can and should be treated, with effect of relief of respiratory symptoms.
Respiratory stridor is a clinical symptom but not a disease. This is the sound arised when air flows through narrowed airways. Ithas never been found in normal conditions. Stridor shows pathologicalimpairment in patency of airway. The pathology in larynx at the glottis generates inspiratory stridor, in subglottis area and in trachea inspiratory-expiratorystridor (1). Airway narrowing may be due to the pathology in their interior, or due to external pressure. The most common cause of congenital respiratory stridoris laryngomalaciacalled asflaccidity of the larynx (2), rarely congenital vocal cord paralysis and congenital stenosis of the cricoid cartilage. Symptoms include: stridor, apnea, dysphonia, dysphagia, choking, recurrent airway infections, chronic cough (3).
The aim of this study is to analyze the congenital respiratory stridor in children.
MATERIAL AND METODS
In the Department of Pediatric Otolaryngology, Medical University of Warsaw in 2010-2013 133 children were hospitalized because of an congenital respiratory stridor. In all 133 children detailed perinatal anamnesisand pediatric examination were done, chest X-ray, than the cranial-ultrasound for neurological assessment and ultrasound of larynx for evaluation ofthe mobility of the vocal cords has been made. In children with abdominal symptoms barium esophagography and ultrasound of abdomen were performed. ECG and echocardiography were performed in cases where the heart murmur was listened or abnormal chest X-ray was described. In each case, the decisive test waslaryngotracheoscopy under general anesthesia using a rigid bronchoscope size appropriate to the age of the patient. In some chest angio-CT scan were performed.
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