Sleep Apnoea & Stridor

Question 1

Define stridor

Answer 1

Predominantly inspiratory wheeze due to large airways (larynx/trachea/major bronchi) obstruction

Question 2

What are the common causes of stridor in children?

Answer 2

1. Infections
2. Foreign Body
3. Anaphylaxis/ angioneurotic oedema
4. Other (e.g. burns)

Question 3

What infections are children likely to have that can cause stridor?

Answer 3

1) Croup
2) Pseudomembranous croup
3) Epiglottitis
4) Retropharyngeal abscess
5) Diphtheria
-due to vaccination
success you’re
unlikely to see this
-fairly common in
some third world
countries
6) Infectious mononucleosis

Question 4

Which of the three infectious causes of stridor is most likely to be life threatening?

a) Pseudomembranous croup
b) Retropharyngeal abscess
c) Epiglottitis

Answer 4

c) Epiglottitis!
If someone has a sore throat and stridor act quickly and admit them because this can become life threatening very quickly

(that’s not to say to not take the others seriously though)

Question 5

How would you know if a foreign body in the airway was the cause of a patient’s breathing difficulties?

Answer 5

History is the key element in diagnosis!

Symptoms:
~acute onset of stridor
~choking spell

Good idea to get airway films and a CXR too

Question 6

What is the most common foreign object in a person’s airway?

Answer 6

Peanuts

Question 7

What age group are most likely to suffer from a foreign body in the airway?

Answer 7

Children < 3 years old.

Question 8

What are the causes of stridor in adults?

Answer 8

Most commonl neoplasms in larynx, trachea or major bronchi but also:

2: Anaphylaxis
3: Goitre
- retrosternal
- enlarged thyroid
4: Trauma
- burns
- strangulation
- irritant gases
5: Other
- bilateral vocal cord palsy
- Wegener’s granulomatosis
- cricoarytenoid arthritis
- tracheopathia