Stridor and drooling in infants and children
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This document discusses various causes of stridor in children under 6 months and over 6 months of age. In infants under 6 months, common causes of stridor include laryngomalacia, vocal cord paralysis, subglottic stenosis, vascular rings, and hemangiomas. For older children over 6 months, common causes are croup, epiglottitis, bacterial tracheitis, foreign body aspiration, and retropharyngeal abscess. Each condition is described in terms of symptoms, diagnostic approach, and treatment options. Croup is highlighted as the most common cause of stridor outside the neonatal period.
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This document defines and describes stridor, which is a noisy breathing sound caused by turbulent airflow through a narrowed airway. It discusses the different types of stridor based on timing in the respiratory cycle. It also explores how and why stridor occurs based on airway dynamics and increased resistance from narrowing. The document outlines how to evaluate stridor through history, examination, and various investigations. Finally, it covers the medical and surgical management of stridor, focusing on oxygen therapy, humidification, intubation, and other approaches depending on the underlying cause of stridor.
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This document discusses stridor, which is a noisy respiration caused by turbulent airflow through a narrowed airway. It defines three types of stridor based on where in the respiratory cycle the noise occurs: inspiratory, expiratory, and biphasic. Common causes of stridor in children include infections like croup as well as foreign objects. Diagnosis involves examining the timing, quality and other characteristics of the noise along with imaging tests to find the specific obstruction. Treatment depends on the underlying cause but may include medications to reduce swelling like steroids or racemic adrenaline to ease breathing.
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2. Flexible laryngoscopy and other scoping procedures are important for evaluating the airway and detecting issues like laryngomalacia. Swallowing disorders are common in children with neurological conditions and may require videofluoroscopy.
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This document discusses various types of noisy breathing and causes of hoarseness and stridor. It describes laryngomalacia as the most common congenital laryngeal anomaly manifesting as inspiratory stridor that is often relieved by prone positioning. For management of obstructed airways, it recommends techniques such as Heimlich maneuver, oropharyngeal/nasal airways, intubation, cricothyroidotomy, tracheostomy based on the level and severity of obstruction. Intubation is preferred over tracheostomy for short term airway issues in children due to easier decannulation and lower risk of subglottic stenosis.
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This document provides an overview of stridor in pediatric patients. It discusses the evaluation and causes of stridor, focusing on the importance of a thorough history and physical exam. Stridor can be caused by issues in the larynx, trachea, or lungs. Imaging like x-rays may provide clues but endoscopy is often needed for definitive diagnosis. Airway issues are of particular concern in young children due to the small size of their airways.
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Stridor is a harsh sound produced by turbulent airflow through a narrowed or obstructed airway. It can occur in the nose, larynx, trachea, or lower respiratory tract. Stridor in infants and children is concerning as their airways are naturally narrow. Minor reductions in airway diameter can cause significant obstruction and difficulty breathing. Acute stridor may be caused by infections like croup or epiglottitis, while chronic stridor can be due to conditions like laryngomalacia. Croup is usually caused by a viral infection causing airway inflammation and narrowing. Epiglottitis is a medical emergency due to risk of complete airway obstruction. Foreign body aspiration is also a risk in
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Pediatric stridor can have various causes related to the anatomy and development of the infant airway. The document discusses several congenital lesions that can cause stridor, including laryngomalacia, the most common cause. It involves the partial or complete collapse of the supraglottic structures during inspiration. Other discussed lesions are laryngeal cysts, bifid epiglottis, laryngeal webs, and congenital vocal fold paralysis. Flexible laryngoscopy is important for diagnosis and management may involve observation, procedures like supraglottoplasty, or tracheostomy for severe cases.
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1. Acute laryngitis is swelling of the laryngeal mucosa and underlying tissue that is commonly caused by viral or bacterial infections, exogenous agents, or autoimmune processes.
2. Symptoms include hoarseness, discomfort in the throat, dry cough, and dyspnea in severe cases. Examination may reveal redness and sticky secretions on the vocal cords.
3. Treatment focuses on rest, steam inhalations, medications to reduce swelling and loosen secretions, and antibiotics for bacterial infections. Children require close monitoring due to risk of airway obstruction.
Presentation1.pptx, radiological imaging of the larngeal diseases.
This document provides an overview of radiological imaging and various diseases of the larynx. It begins by defining the anatomical structures of the larynx, including the supraglottis, glottis, and subglottis. It then discusses several congenital disorders like laryngomalacia, vocal fold paralysis, subglottic stenosis, hemangioma, webs, and atresia. Various inflammatory disorders are also covered such as acute and chronic laryngitis, epiglottitis, tuberculosis, scleroma, candidiasis, sarcoidosis, and laryngo-pharyngeal reflux disease. For each condition, the document discusses epidemiology, etiology, clinical presentation,
Croup
Croup is an inflammation of the larynx and trachea most commonly caused by parainfluenza virus. It presents with inspiratory stridor, barking cough, and hoarseness in children ages 6 months to 3 years. The Westley Croup Score is used to evaluate severity, and treatment depends on score but may include dexamethasone, nebulized epinephrine, and hospitalization for severe cases. Differential diagnoses include epiglottitis, bacterial tracheitis, retropharyngeal abscess, and foreign body aspiration.
Laryngomalacia BY ZAINAB AHMED
Laryngomalacia is the most common congenital larynx anomaly characterized by partial or complete collapse of the supraglottic structures on inspiration, causing noisy breathing in infants. It is usually mild and transient, resolving by age 1-2 years, but may require surgical intervention if respiratory complications develop. Treatment involves managing gastroesophageal reflux if present and in rare cases supraglottoplasty to widen the airway if respiratory distress persists.
Congenital lesions of larynx
This document discusses several congenital laryngeal abnormalities: laryngomalacia, vocal cord paralysis, subglottic stenosis, laryngeal web, subglottic hemangioma, laryngoesophageal cleft, laryngocele, and laryngeal cyst. It provides details on the characteristics, diagnosis, and treatment of each condition. Laryngomalacia is the most common, appearing at birth as excessive flaccidity and stridor that usually resolves by age 2. Flexible laryngoscopy is useful for diagnosing many of these conditions, while treatment depends on the severity but may include observation, steroids, or laser excision.
Paediatric respiratory problems
This document discusses several common pediatric respiratory problems. It begins by outlining signs of respiratory distress and failure in children, including increased respiratory rate and heart rate, nasal flaring, recession of the chest wall, and decreased oxygen saturation despite supplemental oxygen. Specific conditions are then discussed such as croup, epiglottitis, bronchiolitis, pneumonia, whooping cough, inhaled foreign bodies, cystic fibrosis, and heart failure. For each condition, the causes, signs and symptoms, investigations, and management are summarized. The document provides an overview of approaches to evaluating and treating major respiratory issues seen in pediatric patients.
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Evaluation And Management Of Upper Respiratory Tract Infections In Children
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This presentation offers helpful comparison tables, please note that some recommendation might have changed since preparation and publication of this material.
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This document provides information on wheezing and stridor in children, including the causes, clinical features, diagnosis, and management of various conditions. It discusses stridor resulting from infections like croup and epiglottitis. It also covers stridor from congenital causes such as laryngomalacia and vocal cord paralysis. Wheezing can be caused by asthma, infections, cystic fibrosis, and other conditions. The diagnosis and treatment of asthma is discussed in detail, including identifying triggers, clinical assessment, pulmonary function tests, and the goals and components of long-term pharmacological management and education.
RESPIRATORY EMERGENCIES.ppt
This document provides guidance on assessing and managing pediatric respiratory emergencies. It defines respiratory distress, failure, and arrest and outlines how to use the Pediatric Assessment Triangle (PAT) including examining the child's appearance, work of breathing, and circulation. Specific conditions discussed include croup, epiglottitis, foreign body aspiration, asthma, and bronchiolitis. Treatment recommendations are provided for different severity levels. The document stresses the importance of proper assessment to determine if a child needs on-scene treatment or rapid transport to definitive care.
Croup+Diphtheria+ Ac.Epiglottitis
This document discusses several respiratory illnesses that can cause laryngeal obstruction in children, including croup, diphtheria, and acute epiglottitis. Croup is usually caused by parainfluenza or other viruses and presents with a hoarse voice, croupy cough, and stridor. Management focuses on hydration, oxygen, steroids, and nebulized epinephrine. Diphtheria is caused by Corynebacterium diphtheriae and can lead to membrane formation and toxin production and complications like myocarditis. Penicillin and antitoxin are used for treatment. Acute epiglottitis typically affects children ages 1-6 and is commonly caused by Haemophil
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ENT Airway Problems and Emergencies; teaching to Foundation Year (FY) Doctors
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Stridor and drooling in infants and children
- 1. DR ASHMAL
- 2. Stridor is a high-pitched, harsh sound produced by turbulent airflowthrough a partially obstructed airway.
- 3. Stridor in <6 month old Mostly congenital causes 1.LARYNGOMALACIA MOST COMMON CONGENITAL LARYNGEAL ANOMALY IN CHILDREN. stridor worsens with crying and agitation but often improves with neck extension and when the child is prone. usuallymanifests shortly after birth, resolves by 18 months . Definitive diagnosis can obe made with flexible fiberoptic laryngoscopy.
- 5. Vocal cord paralysis congenital or acquired. Unilateral vocal cord paralysis is more common than bilateral cord paralysis and presents with feeding problems, stridor, hoarse voice, and cry changes. Children with bilateral cord paralysis often have a normal voice associatedwith stridor and dyspnea, and symptoms include cyanosis andapneic episodes. Diagnosis is by flexible nasolaryngoscopy. Endotrachealintubation can be difficult with bilateral cord paralysis, and needle cricothyroidotomy and subsequent tracheotomy may be required
- 6. SUB GLOTTIC STENOSIS Prolonged endotracheal intubation in premature babies is the most common cause of acquired subglottic stenosis. VASCULAR RING Congenital anomalies of the aortic arch and pulmonary artery in which anomalous vessels can compress thetrachea or esophagus.
- 7. HEMANGIOMA Benign congenital tumors of endothelial cells or vascular malformations that can occur anywhere on the body.. cutaneous hemangiomas new-onset stridor beginning after the firstmonth of life airway visualization through endoscopy. Although most hemangiomas spontaneously regress, large malformations and those causing significant respiratory symptoms may require treatment with β- blockers, steroids,laser, or surgery.1-3
- 8. STRIDOR IN CHILDREN >6 MONTHS OLD Croup Epiglottitis Bacterial tracheitis Foreign body aspiration Retropharyngeal abscess
- 9. CROUP most common cause of stridor outside the neonatal period, commonly affecting children6 months to 3 years old, with a peak in the second year of life. most common viruses are parainfluenza virus and rhinovirus, followed by enterovirus and respiratory syncytial virus . Clinical features Barking cough,Inspiratory stridor, Symptoms worsens at night . Agitation and crying increases night
- 10. DIAGNOSIS AND TREATMENT CLINICAL Radiograph - STEEPLE SIGN (subglottic narrowing) WESTLEY SCORING SYSTEM Epinephrine 0 .5ML/KG Corticosteroids dexamethasone of 0.6 milligram/kgPO
- 11. EPIGLOTTITIS acute inflammatory condition of the epiglottis that may progress rapidly to life-threatening airway obstruction. Swelling of epiglotis with septicemia m/c organism- H Influenza tybe b Noninfectious causes,such as thermal injury, caustic burns, and direct trauma CLINICAL FEARURES Healthy childs – fever , sorethroat - toxic,difficulty in swallowing,drooling, -tripod or sniffing position with the neckhyperextended and the chin forward to maintain the airway
- 12. DIAGNOSIS Radiograph- thumb sign TEREATMENT -child seated and upright in a position -Oxygen -neb with epinephrine - Intubation - Tracheostomy - Antibiotic- 3rd gen cephalosporins
- 13. AIRWAY FOREIGN BODY Consider foreign body aspiration in a young child with respiratory symptoms, regardless of the duration of symptoms, because many children may present >24 hours after foreign body aspiration sudden coughing and choking
- 14. 3 STAGES -Initial event -Assymptomatic - Complications; fever,hemoptysis,pneumonia DIAGNOSIS Radiograph- chest and neck More than 75% of airway foreign bodies in children <3 years of age are radiolucent.
- 15. RETROPHARYNGEAL ABSCESS The retropharyngeal space occupies the space between the posterior pharyngeal wall and the prevertebral fascia and extends from the base of the skull to the level of the second thoracic vertebrae.
- 16. neck pain, fever, dysphagia, excessive drooling, and neck swelling DIAGNOSIS XRAY NECK,CT TREATMENT stabilize airway iv antibiotics incision and drainage
- 17. PERITONSILLAR ABSCES begins as a superficial infection that progresses to an accumulation of pus in a space between the tonsillar capsule and the superior constrictor muscle. sore throat, fever, chills, trismus, and voice change (“hot potato voice”). Patients will often complain of “the worst sore throat” of their life Oral antibiotics I and d
- 19. THANK YOU