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Paediatric stridor

Estela Pérez Ruiz, Pilar Caro Aguilera, Ana Isabel Valdivielso, Sonia Sanchís Cárdenas, Yazmina Martínez García, Javier Pérez Frías
This paper describes the clinical features of paediatric patients with tracheal bronchus (TB) identified with flexible bronchoscopy (FB) in a tertiary care hospital. A retrospective review of every FB with diagnosis of TB carried out in our centre since 1990 was performed which considered specifically: age at diagnosis, gender, semiology, somatic anomalies, tracheal bronchus type, other bronchoscopic findings and clinical progress. Out of 1665 FB in 1337 patients, TB was found in 26 (1.9%). The median age was 15 months (age range 1 month-13 years), with no gender differences...
May 19, 2018: Paediatric Respiratory Reviews
María Laura Scatolini, Hugo A Rodriguez, Cinthia G Pérez, Alejandro Cocciaglia, Hugo A Botto, Mary Nieto, Lucas Bordino
Bilateral vocal cord paralysis (BVCP) is the second most common cause of neonatal stridor. The aim of this study was to describe the demographic features, aetiology, comorbidities, and management of our patients with BVCP. MATERIAL AND METHODS: We conducted a retrospective review of the clinical charts of all patients diagnosed with BVCP seen at the Department of Respiratory Endoscopy between 2011 and 2015. RESULTS: 47 patients were included. Mean age at diagnosis was 1 month and male sex predominated (63%)...
March 23, 2018: Acta Otorrinolaringológica Española
Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
May 2018: American Journal of Otolaryngology
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
A Ramgolam, G L Hall, D Sommerfield, L Slevin, T F E Drake-Brockman, G Zhang, B S von Ungern-Sternberg
Background: Perioperative respiratory adverse events (PRAE) remain the leading cause of morbidity and mortality in the paediatric population. This double-blinded randomized control trial investigated whether inhaled salbutamol premedication decreased the occurrence of PRAE in children identified as being at high risk of PRAE. Methods: Children with at least two parentally reported risk factors for PRAE undergoing elective surgery were eligible for recruitment. They were randomized to receive either salbutamol (200 µg) or placebo prior to their surgery and PRAE (bronchospasm, laryngospasm, airway obstruction, desaturation, coughing and stridor) were recorded...
July 1, 2017: British Journal of Anaesthesia
Irwin Webster, Pierre Goussard, Robert Gie, Jacques Janson, Gawie Rossouw
BACKGROUND: Bronchoscopy, an important investigation for the diagnosis and management of respiratory diseases, is widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC). AIMS AND OBJECTIVES: Aim was to describe the indications, findings and complications of bronchoscopy in a middle income country with a high prevalence of tuberculosis and HIV. METHODOLOGY: A retrospective analysis of a database over a 3...
February 2017: Expert Review of Respiratory Medicine
J H Bird, S Kumar, C Paul, J D Ramsden
BACKGROUND: Caustic ingestion of acid or alkaline substances can cause damage to the upper respiratory and upper digestive tract. Initial presentation following caustic ingestion can include oropharyngeal pain, dysphagia and stridor. It is due to this clinical presentation that the resident otolaryngologist is consulted to review and examine these patients to assess for airway compromise and commence initial management and care until airway concern has passed. OBJECTIVE OF REVIEW: This review aims to provide evidence-based guidance in the management of those presenting with acute ingestion injury so that informed initial medical therapy can be commenced and appropriate investigations are arranged to optimize patient outcome...
June 2017: Clinical Otolaryngology
Nikhil Arora, Ruchika Juneja, Ravi Meher, Eishaan K Bhargava
Stridor in paediatric age group is not an uncommon presentation to the ENT emergency. The range of differential diagnosis is vast. The presentation may vary from noisy breathing to severe respiratory distress and apnea. Early and meticulous diagnosis is crucial for the management as the condition may be life threatening. We report a rare case series of 3 infants with Arnold Chiari Malformation who presented to the hospital with stridor and were diagnosed with bilateral vocal cord palsy. These 3 infants had similar underlying neurological condition with hydrocephalus and raised intracranial pressure...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
S Mukhopadhyay, S Mukhopadhyay, D Bhattacharya, B K Bandyopadhyay, M Mukherjee, R Ganguly
BACKGROUND: Uncuffed endotracheal tubes are commonly used in children but due to several decade preferred in paediatric oral surgery. Due to lack of conclusive evidences in this regard, we have conducted this study to compare post-operative morbidity following use of cuffed and uncuffed endotracheal tubes in paediatric patients undergoing cleft lip-palate surgery. METHODS: This randomised controlled trial was conducted on children aged 2 to 12 years.110 patients were allocated in two parallel groups using computer generated list of random numbers...
April 2016: Saudi Journal of Anaesthesia
Doreen Nakku, Richard Byaruhanga, Francis Bajunirwe, Imelda T Kyamwanga
BACKGROUND: Aerodigestive foreign bodies (ADFB) in children are a common emergency in ENT clinics globally. The aim of this study was to determine the prevalence and common types of ADFB's presenting to a referral hospital in South Western Uganda, and to review clinical presentation and factors that influence their occurrence among children under 12 years of age. METHODS: We conducted a case control study comprising 40 cases and 80 unmatched controls. Consecutive and random sampling were used for the cases and controls respectively...
2016: BMC Ear, Nose, and Throat Disorders
Behera Ganakalyan, Samal Dilllip Kumar
INTRODUCTION: Fibrolipoma, a subtype of lipoma is painless, well-circumscribed, slow-growing, submucosal benign adipocyte tumour. It is uncommon in the oral cavity and oropharyngeal region, with rare incidence in the retropharynx even rarest in pediatric age group. CASE REPORT: A very unusual case of fibrolipoma is presented in a pediatric patient, who had a huge retropharyngeal fibrolipoma and who presented with breathing difficulty and increasing stridor. It was managed by intro-oral approach excision...
November 2015: Iranian Journal of Otorhinolaryngology
Malak Jamal Gazzaz, Hamdy El-Hakim
A 12-week-old infant girl born at 27 weeks gestation, with multiple comorbidities, was referred to the paediatric otolaryngology team due to stridor and feeding difficulties. Initial airway endoscopy was performed, showing no abnormal findings. The infant underwent frequent hospitalisations for recurrent cyanotic spells. Despite initial laryngoscopy and bronchoscopy not showing abnormalities, a repeat endoscopy demonstrated laryngomalacia, significant enough to require a supraglottoplasty. This is the first report to confirm, with video evidence, that some cases of laryngomalacia are acquired rather than congenital, even in infancy...
December 1, 2015: BMJ Case Reports
Faisal Shamim, Durriya Raza, Mubasher Ikram
The authors report the case of a 4-year boy who required anaesthetic and surgical care during LASER excision of laryngeal papillomatosis. He presented with hoarseness and stridor and underwent emergency tracheostomy after confirmation of laryngeal papillomas on CT scan. He required LASER treatment under general anaesthesia with a requirement of paediatric LASER-safe endotracheal tube but unfortunately, this was not available in the country. Balanced anaesthesia technique using inhalational anaesthetic, muscle relaxant and narcotic is used with modifications...
September 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
J G Barr, H Dean, G Morrison
OBJECTIVE: This paper reports a case of achalasia in a 12-year-old girl who presented with stridor. CASE REPORT: An otherwise healthy 12-year-old girl presented to the ENT clinic with an 18-month history of dysphagia and noisy breathing on eating. Flexible fibre-optic examination showed a normal larynx with normal vocal fold movements. Fibre-optic endoscopic evaluation of swallowing was normal initially, but biphasic stridor occurred after several swallows. Microlaryngoscopy, bronchoscopy and upper oesophagoscopy showed a dilated oesophagus with normal mucosa...
July 2015: Journal of Laryngology and Otology
Nader Ibrahim, Nicola Rachel Wooles, Marianne Elloy, Philip Da Forno
A 2-day-old neonate was transferred to a specialist paediatric otolaryngology centre with stridor at rest, feeding difficulties and an apparent mass in the oropharynx. The newborn displayed evidence of respiratory distress, however, she remained self-ventilating. MRI highlighted a fat-containing lesion in the postnasal space with no intracranial extension. A CT scan under general anaesthesia showed no underlying bony abnormality, and hence an examination of the nasopharynx, oropharynx and microlaryngoscopy and bronchoscopy were performed...
June 8, 2015: BMJ Case Reports
Rameshwar Mhamane, Nandini Dave, Madhu Garasia
BACKGROUND AND AIMS: Traditionally, uncuffed endotracheal tubes have been used in children. Cuffed tubes may be useful in special situations like laparoscopy. Microcuff(®) endotracheal tube is a specifically designed cuffed endotracheal tube for the paediatric airway. We studied the appropriateness of Microcuff(®) tube size selection, efficacy of ventilation, and complications, in children undergoing laparoscopy. METHODS: In a prospective, observational study, 100 children undergoing elective laparoscopy were intubated with Microcuff(®) tube as per recommended size...
February 2015: Indian Journal of Anaesthesia
B S von Ungern-Sternberg, A Ramgolam, G L Hall, P D Sly, W Habre
Three quarters of all critical incidents and a third of all peri-operative cardiac arrests in paediatric anaesthesia are caused by adverse respiratory events. We screened for risk factors from children's and their families' histories, and assessed the usefulness of common markers of allergic sensitisation of the airway as surrogates for airway inflammation and increased risk for adverse respiratory events. One hundred children aged up to 16 years with two or more risk factors undergoing elective surgery were included in the study...
April 2015: Anaesthesia
Shi Ying Hey, Nashreen Banon Oozeer, Stuart Robertson, Kenneth MacKenzie
Laryngomalacia is a dynamic airway condition characterised by inward collapse of flaccid supraglottic structures during inspiration. Although the most common cause of stridor in the paediatric population, adult-onset laryngomalacia remains a rare entity and its management, challenging. Two cases of adult-onset laryngomalacia are reported. A review of the English literature is performed and additional publications identified by hand-searching relevant papers; 13 case reports/series comprising 28 cases of adult-onset laryngomalacia were identified, divided into two main groups: idiopathic (6/28) and acquired (22/28)...
December 2014: European Archives of Oto-rhino-laryngology
Khan A Nazir, Patigaroo Amin Fozia, Mudasir Ul Islam, Ahmed Shakil, Suhail Amin Patigaroo
BACKGROUND: To describe our experience of paediatric patients with acute retropharyngeal abscess in terms of clinical presentation, diagnosis, management and complications. MATERIALS AND METHODS: A prospective study was done for a period of 4 years (Jan 2009 to Jan 2013) on paediatric patients (< 15 years) with acute retropharyngeal abscess at two tertiary hospitals in Srinagar. Diagnosis was made on the basis of X-ray, CECT scan findings and confirmed on incision and drainage...
October 2013: African Journal of Paediatric Surgery: AJPS
F Kirvassilis, D Gidaris, M Ventouri, A Zampouri, M Mylona, A Keramidiotis, Th Kontakiotis, I Tsanakas
BACKGROUND AND AIM: Flexible fiberoptic bronchoscopy (FFB) is one of the most important procedures in paediatric pulmonology. To the best of our knowledge there is no review - audit summarising the experience with FFB in children in Greece. We therefore analysed retrospectively all FFBs performed by the paediatric pulmonology team in our hospital in order to analyse indications for bronchoscopy in our population, explore diagnostic yield for each indication and highlight potential complications...
October 2011: Hippokratia
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