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Pediatric Stridor

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https://www.readbyqxmd.com/read/29200244/management-of-airway-obstruction-and-stridor-in-pediatric-patients-digest
#1
Ashley Marchese, Melissa L Langhan, Kathryn H Pade
Stridor is a result of turbulent air-flow through the trachea from upper airway obstruction, and although in children it is often due to croup, it can also be caused by noninfectious and/or congenital conditions as well as life-threatening etiologies. The history and physical examination guide initial management, which includes reduction of airway inflammation, treatment of bacterial infection, and, less often, imaging, emergent airway stabilization, or surgical management. This issue discusses the most common as well as the life-threatening etiologies of acute and chronic stridor and its management in the emergency department...
November 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29084070/utility-of-soft-tissue-lateral-neck-radiographs-in-the-emergency-department-the-5-year-experience-of-a-large-tertiary-care-pediatric-hospital
#2
Tais Sao Pedro, Dennis Scolnik, Jeffrey Traubici, Derek Stephens
INTRODUCTION: Although retropharyngeal infection (RPI) may present with voice change, drooling, fever, and a toxic appearance, diagnosis based on symptoms alone is unreliable. As incidence is increasing in children and drug-resistant bacterial strains such as methicillin-resistant Staphylococcus aureus are becoming more common, we decided to assess the clinical utility of lateral neck radiography. OBJECTIVE: The aim of this study was to review the experience of a large tertiary care pediatric emergency department (ED) in using lateral soft tissue neck radiographs in the diagnosis of suspected RPI...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29068802/emergency-ventilation-of-infant-subglottic-stenosis-through-small-gauge-lumen-using-the-ventrain-a-case-report
#3
Francisco J Escribá Alepuz, Javier Alonso García, J Vicente Cuchillo Sastriques, Emilio Alcalá, Pilar Argente Navarro
Postintubation subglottic stenosis is one of the most common causes of stridor in newborns and babies after prolonged mechanical ventilation. Management of this pathology is complex and requires highly trained personnel because it is associated with a high rate of airway-related mortality. This article presents the rescue of a difficult airway in a pediatric patient with subglottic stenosis with a new device available on the market, the Ventrain, offering certain advantages over those available until now.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
October 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29066919/differentiating-vocal-cord-dysfunction-from-asthma
#4
REVIEW
Andrew Fretzayas, Maria Moustaki, Ioanna Loukou, Konstantinos Douros
Vocal cord dysfunction (VCD)-associated symptoms are not rare in pediatric patients. Dyspnea, wheezing, stridor, chest pain or tightness and throat discomfort are the most commonly encountered symptoms. They may occur either at rest or more commonly during exercise in patients with VCD, as well as in asthmatic subjects. The phase of respiration (inspiration rather than expiration), the location of the wheezing origin, the rapid resolution of symptoms, and the timing occurring in relation to exercise, when VCD is exercise induced, raise the suspicion of VCD in patients who may have been characterized as merely asthmatics and, most importantly, had not responded to the appropriate treatment...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29045097/management-of-airway-obstruction-and-stridor-in-pediatric-patients
#5
Ashley Marchese, Melissa L. Langhan
Stridor is a result of turbulent air-flow through the trachea from upper airway obstruction, and although in children it is often due to croup, it can also be caused by noninfectious and/or congenital conditions as well as life-threatening etiologies. The history and physical examination guide initial management, which includes reduction of airway inflammation, treatment of bacterial infection, and, less often, imaging, emergent airway stabilization, or surgical management. This issue discusses the most common as well as the life-threatening etiologies of acute and chronic stridor and its management in the emergency department...
November 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28782910/eucapnic-voluntary-hyperventilation-test-in-children
#6
Janne Burman, Heikki Lukkarinen, Varpu Elenius, Sami Remes, Tom Kuusela, Tuomas Jartti
BACKGROUND: In children, exercise-induced dyspnea is a common symptom that can be due to dysfunctional breathing. EVH test has bee used especially in elite athletes as bronchoprovocation test. Currently, there are only few studies on the EVH test. New research methods are required alongside the traditionally used tests especially due to dysfunctional breathing disorder. PURPOSE: The purpose of the "pilot study" was to study the usability of the EVH test with real time biofeedback in children of 10-16 years of age in the diagnostics of exercise-induced dyspnea...
August 7, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28521330/pediatric-penetrating-neck-trauma-hard-signs-of-injury-and-selective-neck-exploration
#7
Rober A Tessler, Huong Nguyen, Christoper Newton, James Betts
BACKGROUND: Selective neck exploration and computed tomography angiography (CTA) in penetrating neck trauma have been well described in adults. However, data in the pediatric population are sparse. The extent to which these practices have been adopted in pediatric patients is unknown. METHODS: Retrospective, single-center cohort study of pediatric penetrating neck trauma for the years 2001 to 2014 in a dedicated children's hospital/Level 1 pediatric trauma center...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28483222/endoscopic-management-of-bilateral-vocal-fold-paralysis-in-newborns-and-infants
#8
Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28267266/propranolol-treatment-for-infantile-hemangioma-does-not-increase-risk-of-childhood-wheezing
#9
Meir Mei-Zahav, Hannah Blau, Moshe Hoshen, Alex Zvulunov, Huda Mussaffi, Dario Prais, Patrick Stafler, Guy Steuer, Moshe Lapidoth, Dan Ben Amitai
OBJECTIVE: Propranolol is the treatment of choice for infantile hemangiomas requiring medical intervention. Although contraindicated in asthma, its bronchoconstrictive effect in infants and children has not been extensively studied. We aimed to assess the incidence of wheezing episodes in infants and children treated with propranolol for infantile hemangiomas. STUDY DESIGN: A retrospective case-control study. SETTING: a tertiary pediatric hospital...
August 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28217159/managing-tracheal-extubation-in-infants-with-stridor-and-congenital-neuraxial-anomalies
#10
Deepti Saigal, Pragati Ganjoo, Megha U Sharma, Daljit Singh
Stridor is a serious complication of congenital neuraxial anomalies, which though, can get completely resolved with early neurosurgical correction of the anomaly. However, stridor relief may or may not be achieved soon after surgery. Persistent postoperative stridor can potentially cause extubation failure that may be difficult to handle in small children. There are no extubation guidelines for difficult pediatric airways as yet, and fewer appropriate airway-assist devices for routine use. Management of an infant with occipital encephalocele, hydrocephalus and bilateral abductor vocal cord palsy, who developed post-extubation respiratory distress due to stridor is discussed, together with the relevant tracheal extubation issues in such cases...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28207796/post-extubation-stridor-in-respiratory-syncytial-virus-bronchiolitis-is-there-a-role-for-prophylactic-dexamethasone
#11
Esther S Veldhoen, Charlotte A Smulders, Teus H Kappen, Job C Calis, Job van Woensel, Paulien A M Raymakers-Janssen, Louis J Bont, Marije P Hennus
AIM: The purpose of this study was to determine the incidence of reintubation due to upper airway obstruction in a homogeneous group of ventilated infants with Respiratory Syncytial Virus bronchiolitis. Our secondary objective was to determine whether prophylactic administration of dexamethasone prior to extubation was associated with decreased risk of reintubation. METHODS: This retrospective observational study in two Pediatric Intensive Care Units in 2 university hospitals in The Netherlands included two hundred patients younger than 13 months admitted with respiratory insufficiency caused by Respiratory Syncytial Virus bronchiolitis, requiring invasive mechanical ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/28148461/measuring-quality-of-life-in-pediatric-paradoxical-vocal-fold-motion-using-the-sf-36v2
#12
Kershena S Liao, Paul E Kwak, Hazel Hewitt, Sarah Hollas, Julina Ongkasuwan
OBJECTIVES: Paradoxical vocal fold motion (PVFM) consists of intermittent adduction of the vocal folds during inspiration, resulting in stridor and worsened by anxiety and stress. The purpose of this study was to assess the impact of PVFM on quality of life in our pediatric patient population. STUDY DESIGN: This is a prospective, descriptive survey study. METHODS: Thirty-nine consecutive patients (ages 12-17 years) presenting with a PVFM diagnosis for respiratory retraining sessions with speech-language pathology were recruited...
January 30, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28093934/efficacy-and-safety-of-oral-sildenafil-in-treatment-of-pediatric-head-and-neck-lymphatic-malformations
#13
Shengcai Wang, Jie Zhang, Wentong Ge, Yuanhu Liu, Yongli Guo, Yue Liu, Ning Wang, Yuzhu He, Jun Tai, Xin Ni
CONCLUSIONS: Low dose oral sildenafil citrate tablets are safe and effective to decrease the lesions volume in some LMs children, especially with macrocystic lesion or mixed type. OBJECTIVE: To evaluate the efficacy and safety of oral sildenafil in treatment of pediatric head and neck lymphatic malformations (LMs). SUBJECTS AND METHODS: In this open-label study, 21 children diagnosed with LMs were given oral sildenafil and stopped at week 24...
June 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28093564/postoperative-conversion-disorder-presenting-as-inspiratory-stridor-and-hemiparesis-in-a-pediatric-patient
#14
Erik J Nelson, Jennifer Y Wu
BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness...
January 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/27913710/lessons-learned-from-35-cases-of-laryngeal-foreign-bodies-undergoing-misdiagnosis-in-pediatric-population
#15
Qingguo Chen, Hanqi Chu, Yanling Tao, Hongyan Huang, Liyan Peng
OBJECTIVES: To present 35 cases of laryngeal foreign bodies (FBs) in pediatric population undergoing misdiagnosis so as to draw on our lessons to improve early diagnosis. METHODS: A retrospective analysis over 15 years was conducted of 35 cases of laryngeal FBs undergoing misdiagnosis in children. Meanwhile, a control group, including 42 cases of laryngeal FBs without misdiagnosis in children, was set. These patients' clinical data were collected and analyzed to identify the risk factors for misdiagnosis...
February 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27900765/the-role-of-the-otolaryngologist-in-the-evaluation-and-diagnosis-of-eosinophilic-esophagitis
#16
Mark Kubik, Prasad Thottam, Amber Shaffer, Sukgi Choi
OBJECTIVE: To describe the clinical presentation and role of the otolaryngologist in the evaluation of eosinophilic esophagitis (EoE) at a tertiary pediatric hospital. STUDY DESIGN: Retrospective review. METHODS: Records from pediatric patients with a diagnosis of EoE from 2003 to 2015 were reviewed. Study variables were analyzed to compare patients presenting to different specialties. RESULTS: Two hundred and fifty-one patients with EoE were evaluated...
June 2017: Laryngoscope
https://www.readbyqxmd.com/read/27872941/-supraglottoplasty-for-pediatric-laryngomalacia-results-from-71-cases
#17
D Di Dio, P Amrhein, A Koitschev, C Sittel
Laryngomalacia is the most common cause of stridor in infants. The stridor is caused by an inward collapse of supraglottic structures during inspiration resulting in an inspiratory stridor. The exact etiology still remains unclear. The surgical procedure of choice for laryngomalacia is supraglottoplasty. From 2009 to 2016 a total of 71 children were treated by supraglottoplasty in the department for pediatric otorhinolaryngology of the Stuttgart Hospital. The indications for supraglottoplasty were laryngomalacia with severe inspiratory stridor, oxygen desaturation, suprasternal or chest retraction, feeding difficulties and/or failure to thrive...
December 2016: HNO
https://www.readbyqxmd.com/read/27808413/a-new-solution-for-neonatal-bilateral-vocal-cord-paralysis-endoscopic-arytenoid-abduction-lateropexy
#18
Shahram Madani, Ádám Bach, Vera Matievics, Eszter Erdélyi, Balázs Sztanó, Ilona Szegesdi, Paul F Castellanos, László Rovó
OBJECTIVES/HYPOTHESIS: Bilateral vocal cord paralysis in early childhood is a life-threatening condition, which often requires immediate intervention. One of the treatment options is a quick, reversible simple suture vocal cord lateralizing technique, whereby the arytenoid cartilage is directly lateralized to the normal abducted position. Considering pediatric laryngeal anatomy, a small endolaryngeal thread guide instrument was designed for precise suture insertion. STUDY DESIGN: New instrument validation...
July 2017: Laryngoscope
https://www.readbyqxmd.com/read/27729125/paradoxical-vocal-fold-motion-in-children-presenting-with-exercise-induced-dyspnea
#19
Anne Hseu, Mykayla Sandler, Dawn Ericson, Nohamin Ayele, Kosuke Kawai, Roger Nuss
INTRODUCTION: Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. METHODS: A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015...
November 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27722004/alte-and-feeding-intolerance-as-a-presentation-of-double-aortic-arch
#20
Rekha Krishnasarma, Liza Green Golan Mackintosh, Francine Bynum
Many children who are admitted to pediatric hospitals with the chief complaint of apparent life-threatening event (ALTE) are, in fact, well appearing by the time the inpatient medical team evaluates the patient. This presents a diagnostic and therapeutic challenge. We describe a case of a six-month-old full-term female presenting with an ALTE and found to have a double aortic arch, a congenital anomaly that usually presents with a more progressive onset of symptoms such as chronic cough, positional stridor, and feeding difficulties...
2016: Case Reports in Pediatrics
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