stridor Flashcards
what is stridor ?
difficult noisy respiration due to partial upper airway obstruction
what are the sites associated with striddor ?
larynx and/or trachea
what are the different types of stridor ?
inspiratory
biphasic
expiratory
where is the affection in inspiratory stridor ?
supraglottic or glottic
where is the affection in biphasic stridor ?
subglottic or tracheal
where is thee affection in expiratory stridor ?
bronchial
what are thee geneeral causes of stridor ?
congenital
traumatic
inflammatory
miscellaneous
tracheal
what are the congenital causes for stridor ?
laryngomalacia
laryngeal web
subglottic stenosis
subglottic hemangioma
cyst
bilateral vocal cord paralysis
what is the most common congential cause of stridor ?
laryngomalacia
what is the pathophysiology associated with laryngomalacia ?
cartilaginous framework of the larynx is abnormally soft and gets collapsed during inspiration
this improves when put in prone position
what is the prognosis and treatment for laryngomalacia ?
usually requires no intervention and improves by the age of 12-18 months
what is the pathology with laryngeal webs ?
incomplete canalization of the laryngeal lumen
what is the clinical picture of laryngeal webs ?
asymptomatic or weak hoarse cry
stridor if the web is largein size
what is thee treatment for laryngeal webs ?
no treatment required if asymptomatic
microlaryngeal surgery
tracheostomy if airway is compromised
what is the cause of congenital subglottic stenosis ?
in utero malformation of the cricoid cartilage
what is the clinical picture of congeenital subglottic stenosis ?
persistent stridor
recurrent episodes of croup
failure to thrive
what is the treatment of choice in congenital subglottic stenosis ?
dilatation
crico tracheoplasty
what is the most common cause of acquired subglottic stenosis in ICU pts?
prolonged intubation
what are the inflammatory causes of stridor ?
acute laryngitis
chronic specific laryngitis
acute epiglottitis
Croup
what are the causes of acute laryngitis ?
post upper respiratory tract infection
viral : influenza, parainfluenza, rhinovirus
bacterial: strp. pneumonia
what is the clinical picture of acute laryngitis ?
general manifestations: fever headache and malaise
hoarseness
discomfort and pain on phonation
dry cough
mucopurulent discharge
difficulty in breathing in severe cases
what is the treatment for acute laryngitis ?
rest
warm fluids
humidification
mucolytic
pain manageement
why is acute epiglottitis not a common cause of stridor anymore ?
due to Hib vaccine (haemophilus influenza vaccine)
what is the clinical picture of acute eepiglottitis ?
severe odynophagia
drooling of saliva
muffled hot potato voice
rapid progressive stridor
what is the treatment for acute epiglottitis ?
as acute laryngitis conservative
proper airway management is crucial
what is tthe main symptom of croup ?
seal like barking cough
what is the most common causative organism of croup ?
parainfluenza virus
what are the benign neoplasms that can present with stridor ?
recurrent respiratory papillomatosis
what is the causative organism in recurrent respiratory papillomatosis ?
human papillomavirus
what is the treatment of choice in recurrent respiratory papillomatosis ?
CO2 laser ablation
however has a high incidence of recurrence
what are the malignant causes of stridor ?
laryngeal carcinoma (squamous cell carcinoma )
what are the miscellaneous causes of stridor ?
bilateral vocal cord paralysis
laryngeal oedema
what are the tracheal causes of stridor ?
retrosternal goiter
mediastinal LN
post thyroidectomy a patient presents with stridor ?
bilateral vocal corrd paralysis
old age patient with a history of smoking presenting with hoarseness , is suggestive of ?
laryngeal carcinoma
