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Paediatric stridor

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...
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...
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
Isabel Garcia-Lopez, Julio Peñorrocha-Teres, Magdalena Perez-Ortin, Mauricio Cerpa, Ignacio Rabanal, Javier Gavilan
INTRODUCTION AND OBJECTIVES: Vocal fold paralysis (VFP) is a relatively common cause of stridor and dysphonia in the paediatric population. This report summarises our experience with VFP in the paediatric age group. METHODS: All patients presenting with vocal fold paralysis over a 12-month period were included. Medical charts were revised retrospectively. The diagnosis was performed by flexible endoscopic examination. The cases were evaluated with respect to aetiology of the paralysis, presenting symptoms, delay in diagnosis, affected side, vocal fold position, need for surgical treatment and outcome...
July 2013: Acta Otorrinolaringológica Española
Wong Birgitta Yee-Hang, Hui Theresa, Lee So-Lun, Ho Wai-Kuen, Wei William Ignace
Stridor is the main symptom of upper airway obstruction in infants. It can be congenital or acquired, acute or chronic. Pathologies can be located from the nose down to the trachea. Common causes include laryngomalacia, vocal cord palsy, subglottic stenosis, tracheal anomaly, laryngeal cleft, vascular and lymphatic malformation, laryngeal papillomas, craniofacial abnormalities and even head and neck tumours. In this paper, we will discuss our approach to infants with stridor including assessment with flexible and rigid endoscopy and treatments to various conditions in a tertiary centre...
2012: ISRN Otolaryngology
Ahsan Rao, Nicola Starritt, Julia Park, Haytham Kubba, Andrew Clement
OBJECTIVE: Subglottic stenosis is the third most common cause of stridor in children, and severe cases may need surgical reconstruction. Babies born to parents in high-deprivation areas are at increased risk of prematurity and low birth weight. This may require intensive care admission with prolonged intubation, hence, putting them at increased risk of subglottic stenosis. We aimed to review cases of subglottic stenosis requiring surgical intervention in the Scottish population and its association with socio-economic deprivation...
July 2013: International Journal of Pediatric Otorhinolaryngology
Shruti Jayachandra, Guy D Eslick
BACKGROUND: Foreign body ingestion is a common problem among paediatric populations. A variety of foreign bodies are ingested, some of which are particularly harmful and life threatening such as button batteries, magnets and bones. Common household items such as small toys, marbles, batteries and erasers are often ingested. The aim of this systematic review is to study the problem of foreign body ingestion among paediatric populations in terms of commonly ingested objects, and attempt to identify the link between location of impaction, associated symptoms, complications, spontaneous passage, methods and timing of removal...
March 2013: International Journal of Pediatric Otorhinolaryngology
Sonal Amit, Neetu Purwar, Asha Agarwal, Devendra Lalchandani
Follicular lymphomas (FL) are among the most common non-Hodgkin's lymphoma (NHL) in adults. However, they are rare in children making up less than 3% of paediatric NHL cases. They occur most commonly in the head and neck region, lymph nodes or tonsils, with occasional extra-nodal occurrences. Distinction of FL from potentially clonal but, reactive follicular hyperplasia is important. We report a case of a 6-year-old male child presenting with night stridor since 6 months. Clinical examination revealed asymmetrical enlargement of the left tonsil...
2012: BMJ Case Reports
Kevin Kulendra, Joseph Mullineux, Ann-Louise McDermott, Helen Williams
The contrast swallow has traditionally been used in the investigation of paediatric stridor with the aim of identifying pathology such as vascular rings and confirming the presence of gastro-oesophageal reflux. Currently, a laryngotracheobronchoscopy (LTB) is the gold standard investigation for stridor and frequently, a child is commenced on antireflux medications based on clinical history. We seek to identify whether a contrast swallow has a valuable and cost effective role in the investigation of paediatric stridor...
March 2013: European Archives of Oto-rhino-laryngology
Michele Loizzi, Angela De Palma, Vincenzo Pagliarulo, Nicola Quaranta
Subglottic haemangioma (SGH) is a rare, benign tumour in children, which is potentially life-threatening because of airway obstruction. We report the case of a full-term 2-month-old infant girl admitted to our institution with stridor, dyspnoea and oxygen desaturation caused by a SGH and treated with propranolol. Neck-chest computed tomography (CT) revealed a contrast-enhancing, 10-mm, subglottic elliptic lesion, referable to SGH. Pre-treatment fibrobronchoscopy showed a sub-occlusive SGH closing more than 75% of the laryngotracheal airway...
January 2013: European Journal of Cardio-thoracic Surgery
Pankaj Kundra, Sandeep Kumar Mishra, Anathakrishnan Ramesh
Currently, the role of ultrasound (US) in anaesthesia-related airway assessment and procedural interventions is encouraging, though it is still ill defined. US can visualise anatomical structures in the supraglottic, glottic and subglottic regions. The floor of the mouth can be visualised by both transcutaneous view of the neck and also by transoral or sublinguial views. However, imaging the epiglottis can be challenging as it is suspended in air. US may detect signs suggestive of difficult intubation, but the data are limited...
September 2011: Indian Journal of Anaesthesia
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