Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STRIDOR”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMed1998

Fourth branchial pouch anomalies: a study of six cases and review of the literature.

A retrospective study in the ENT departments of the Timone Children's Hospital in Marseille and the Armand Trousseau Hospital in Paris and a review of the literature was performed in order to update knowledge about fourth branchial pouch anomalies. Over the 12-year period studied, a total of six children were treated: three boys and three girls. The lesions were located on the left side in all cases and infection was the most common manifestation. Clinical presentation ranged from suppurative thyroiditis in most cases to stridor in a few newborns. The most useful diagnostic examinations are CT-scan of the neck and endoscopy of the pyriform sinus. The authors emphasize the need for complete surgical resection including the cyst and fistulous tract down to the pyriform sinus.

Branchial Region↗
PubMed1998

Teratoma in a newborn: an unusual cause of airway obstruction.

We report the case of a newborn girl who presented with an inspiratory stridor and apneic episodes due to a mass in the oropharynx. On flexible pharyngo-laryngoscopy, it appeared that on inspiration this swelling, originating from the oropharynx, was sucked into the larynx, obstructing the airway. After intubation under flexible optic control the swelling was excised using the CO2-laser. Histopathological examination showed a teratoma of the oropharynx. The postoperative course was uneventful. Teratomas of the oropharynx are rare and are treated by surgical excision. If respiratory distress accompanies the lesion, priority must be given to securing the airway.

Airway Obstruction↗
PubMed1999

Bifid epiglottis.

Bifid epiglottis is a rare congenital defect that is often associated with other congenital annomalies. The most common defect associated with a bifid epiglottis are anomalies of the hands and/or feet (90%) while the most dangerous and potentially lethal anomaly if not recognized and treated are hypothalamic hamartomas and hypopituitarism (50%). A bifid epiglottis will often result in severe respiratory distress secondary to laxity of the cartilage and chronic aspirations, which may require surgical intervention. We present the case of a 10-week-old child who was sent for evaluation of stridor and aspiration. Office laryngoscopy demonstrated a true bifid epiglottis and further evaluation demonstrated a hypothalamic hamartoma consistent with Pallister-Hall syndrome. Management of our case as well as those previously presented in the literature are reviewed.

Child, Preschool↗
PubMed1999

Neuralgic amyotrophy presenting with bilateral vocal cord paralysis in a child: a case report.

Acute stridor and bilateral vocal cord paralysis is not uncommon in the neonate but is unusual in the older child. We report the first case of bilateral vocal cord paralysis secondary to neuralgic amyotrophy, a peripheral polyneuropathy, in a 5-year-old child. An extensive workup revealed a paralyzed right hemidiaphragm, arm weakness and an EMG pattern consistent with neuralgic amyotrophy. Neuralgic amyotrophy is an uncommon disorder in pediatric patients which may involve cranial and peripheral nerves including the phrenic nerves and rarely the recurrent laryngeal nerves. We propose that the diagnosis be considered in children who present with bilateral vocal cord paralysis and other associated neurologic findings.

Brachial Plexus↗
PubMed1999

Cricotracheal resection for pediatric subglottic stenosis.

Until recently, cricotracheal resection (CTR) has not been commonly accepted as a treatment modality for severe subglottic stenosis in the pediatric age group. The reasons have included the risk of a possible dehiscence at the site of the anastomosis, the likelihood of injury to the recurrent laryngeal nerves, and the interference with normal growth of the larynx. Thirty-eight infants and children with a severe subglottic stenosis underwent a partial cricoid resection with primary thyrotracheal anastomosis. Thirty-three patients were tracheotomy-dependent at the time of surgery and 34 were referred cases; 27 were classified as grade III, and 10 as grade IV stenoses according to new Cotton's classification. Nineteen patients were younger than 3 years of age at the time of surgery. The tracheotomy was resected during the surgical procedure in 21 cases. Decannulation was achieved in 36/38 cases after an open procedure. There is one complete restenosis and one good result awaiting decannulation after further surgery for a Pierre Robin syndrome. The authors experienced no lesion of the recurrent laryngeal nerves and no fatality. Thirty-one patients show no exertional dyspnea, three a slight stridor while exercising, and two patients are not decannulated. The postoperative follow-up in longer than 10 years in eight cases. All patients show a normal growth of the larynx and trachea. Compared to laryngotracheoplasties, CTR gives better results for severe subglottic stenosis. This operation should become the treatment of choice for severe (grade III and IV) subglottic stenosis in infants and children.

Child↗
PubMed1999

Laryngeal hamartoma: surgical management.

A newborn female infant with severe inspiratory stridor was found to have a laryngeal non-encapsulated hamartoma in the supraglottic area, medial to the hyoid bone and extending into the petiole of the epiglottis. Histologic examination revealed an extremely uncommon glandular hamartoma. Surgical management in the newborn period consisted of conservative endoscopic excision combined with open laryngofissure. The hamartoma was removed in the newborn period to avoid tracheostomy, because decanulation after tracheostomy in infants can be difficult.

Endoscopy↗
PubMed1995

Endoscopic laser treatment of benign tracheal stenoses.

We present the technique and results of endoscopic neodymium-yttrium aluminum garnet laser treatment of benign tracheal stenoses. This therapy was used in 15 patients with tracheal stenoses. Benign tracheal granulomas were caused by prolonged tracheal intubation in eight patients, permanent maintenance of tracheostomy tube in five patients, and nonspecific inflammatory process of the trachea in two patients. The clinical picture was dominated by dyspnea and stridor. The achievement of normal tracheal patency required several laser therapy sessions, repeated at 5- to 7-day intervals. In 30% of patients additional laser vaporization was required as well. The immediate and short-term results were encouraging; in all cases the normal tracheal lumen was restored, resulting in alleviation of patients' symptoms.

Adult↗
PubMed1999

Predicting airway risk in angioedema: staging system based on presentation.

Angioedema is an immunologically mediated, anatomically limited, nonpitting edema that can lead to life-threatening airway obstruction. To predict the risk of airway compromise in angioedema, we retrospectively reviewed 93 episodes in 80 patients from 1985 to 1995. Intubation or tracheotomy was necessary in 9 (9.7%) cases. Angiotensin-converting enzyme inhibitor use in 36 cases (39%) was associated with intensive care unit (ICU) admission (P = 0.05). ICU stay correlated significantly with presentation with voice change, hoarseness, dyspnea, and rash (P < 0.05). Voice change, hoarseness, dyspnea, and stridor were present in patients requiring airway intervention (P < 0.05). On the basis of our data, we propose a staging system by which airway risk may be predicted from the anatomic site of presentation. Patients with facial rash, facial edema, lip edema (stage I), and soft palate edema (stage II) were treated as outpatients and on the hospital ward. Patients with lingual edema (stage III) usually required ICU admission. All patients with laryngeal edema (stage IV) were admitted to the ICU. Airway intervention was necessary in 7% of stage III patients and in 24% of stage IV cases. No deaths were caused by angioedema. Airway risk in angioedema may be predicted by anatomic site of presentation, allowing appropriate triage with preparation for airway intervention in selected cases.

Adolescent↗
PubMed1999

Reflux in infants with laryngomalacia: results of 24-hour double-probe pH monitoring.

Laryngomalacia is the most common cause of stridor in children. Previous studies using barium esophagrams or single-probe esophageal pH testing have indicated that 68% to 80% of infants with laryngomalacia have reflux. A recent study in a large series of pediatric patients has shown that these 2 testing modalities are relatively insensitive in detecting reflux when compared with 24-hour double-probe pH testing. This study was undertaken to determine the incidence and frequency of reflux in children with laryngomalacia by use of 24-hour double-probe pH monitoring. Twenty-four children with endoscopically diagnosed laryngomalacia underwent 24-hour double-probe pH testing. The distal probe was placed in the lower esophagus, and the proximal probe was placed just above the cricopharyngeus immediately posterior to the larynx. All 24 (100%) children had pharyngeal acid exposure as judged by the proximal pH probe. These children had a mean of 15.21 episodes of reflux to the level of the pharynx during the 24-hour study period. In contrast, only 16 (66%) children had abnormal acid exposure as measured by the distal esophageal probe. These results indicate that essentially all children with laryngomalacia have reflux of gastric acid to the pharyngeal level. Multiple authors have documented the detrimental effects of acid and the accompanying pepsin in the larynx and tracheobronchial tree. Persistent laryngeal edema is an almost universal finding in patients with reflux to the pharyngeal level and is a common finding in children with laryngomalacia. In some patients with laryngomalacia, reflux may be the primary cause of their airway compromise, whereas in others it may be a significant cofactor exacerbating a preexisting neurologic or anatomic abnormality.

Female↗
PubMed1996

Caustic and thermal epiglottitis in the adult.

The presence of dysphagia, drooling, and stridor in an adult subsequent to thermal or caustic injury should alert the treating physician to the possibility of injury to the supraglottic structures with resultant epiglottitis. These adults possess many of the features seen in acute infectious epiglottitis and should be handled with the same consideration for potential upper airway obstruction. Epiglottic injuries of this type should be suspected in adults with mental disorders or communication difficulties.

Adult↗
PubMed1997

Closure of permanent tracheostomy in patients with sleep apnea: a comparison of two techniques.

A "permanent" skin-lined tracheostomy is used for patients with severe obstructive sleep apnea syndrome who fall, refuse, or can't tolerate continuous positive airway pressure. Closure of the stoma may be performed if the apnea has been controlled by surgeries that enlarge and stabilize the upper airway, if adequate weight loss occurs, or if the patient decides to accept continuous positive airway pressure. Two different closure techniques are compared. Sixty-nine three-layer closures were performed in 66 patients from 1980 to 1990. Postoperative complications, including stridor, subcutaneous emphysema, pneumomediastinum, tracheal granuloma, hematoma, and respiratory arrest, occurred in 30% of patients, and three required reopening of their tracheostomy sites. After 1990 a simple deepithelialization technique was used in 10 patients without any major complications. This technique is simpler and quicker and can be performed with the patient under local anesthesia.

Adult↗
PubMed1984

Acromegaly in the dog.

The main characteristic findings in canine acromegaly are a visible increase in soft tissue mass, prominent skin folds, abdominal enlargement, and/or radiographic evidence of an increase in soft tissue mass in the orolingual, oropharyngeal, and orolaryngeal region. Acromegalic dogs almost invariably show some degree of respiratory stridor. Enlargement of the interdental spaces can be seen, but it is felt that these changes are less specific for the disease. Other possible findings include hyperglycemia, PU/PD, elevated SAP levels, and lowered PCV. For a conclusive diagnosis, the demonstration of elevated GH levels and, preferably, the demonstration of nonsuppressibility of these high GH levels is required. Basal plasma GH levels in acromegalic dogs varies considerably (for example, from 10 ng per ml to approximately 1500 ng per ml). GH-dependent circulating growth factor (that is, insulin-like growth factor I) is drastically elevated. Acromegaly is encountered in intact female dogs that were treated with progestagens to prevent estrus and in dogs during diestrus (progesterone phase). Progestagen withdrawal and/or ovariohysterectomy will result in a reduction of plasma GH and GH-dependent insulin-like growth factor concentrations and appreciable clinical improvement.

Acromegaly↗
PubMed1990

Laryngoscopy.

The larynx normally functions in vocalization, deglutition, and respiration. There is no substitute for direct laryngoscopy in animals suspected of having laryngeal disease. Clinical signs that should alert the veterinarian include cough, choking while eating or drinking, exertional cyanosis and syncope, noisy breathing, inspiratory dyspnea, stridor, and significant change in sound production. Controlled anesthesia is mandatory for animals with suspected laryngeal disease because many of these patients have compromised respiratory function. Laryngoscopy is used to note abnormalities in the shape, color, and motility of the larynx with special attention to correlating the movement of the arytenoid cartilages and vocal folds with the respiratory cycle.

Animals↗
PubMed2003

When is a patient safe for discharge after procedural sedation? The timing of adverse effect events in 1367 pediatric procedural sedations.

STUDY OBJECTIVES: The optimal timing of discharge from the emergency department (ED) after pediatric procedural sedation and analgesia has not been well studied. Because concern about delayed adverse effects commonly delays discharge after sedation, we attempted to establish the timing of adverse effects in our cohort of procedural sedations. METHODS: We analyzed data from a prospectively generated database comprising consecutive sedation events throughout a 2-year period. We determined the timing of serious (eg, hypoxia, stridor, hypotension) and other adverse effects from final medication administration and calculated adverse effect risk ratios in relation to sedation characteristics. RESULTS: In 1341 sedation events, there were 184 (13.7%) adverse effects, of which 159 (11.9%) were serious. The median age of children with and without adverse effects was similar (64 months in both groups). Most adverse effects occurred during the procedure (92%) rather than after the procedure (8%). Serious adverse effects occurred a median of 2 minutes after final medication dose (range -106 to +40 minutes). One hypoxic episode occurred each at 26, 30, and 40 minutes after final medication administration; all were repeated occurrences in children who had experienced previous hypoxia during the expected peak drug effect. CONCLUSION: Adverse effects were common; however, serious adverse effects rarely occurred after 25 minutes from the final medication administration. Those that did occur this late were all preceded by a separate similar adverse effect during the expected peak drug effect, which suggests that when similar medication regimens are used, discharge from the ED may be safe at approximately 30 minutes after final sedation medication administration if no adverse effects have occurred.

Adjuvants, Anesthesia↗
PubMed1990

Cervical lung herniation associated with upper airway obstruction.

We present the case of a 6-year-old boy with reactive airway disease who developed cervical lung herniation resulting in compression of the trachea and audible stridor. This association has never been reported in the pediatric age group, and a review of the literature revealed that lung herniation is a rare condition in the pediatric population. Most patients are asymptomatic. Herniation occurs in the cervical area in approximately one fourth of patients. The diagnosis is usually made by physical examination and confirmed by radiographic studies. Treatment is seldom necessary; most patients require only education and reassurance. Surgical intervention is indicated when respiratory distress, cosmetic concerns, or progressive increase in size occur.

Airway Obstruction↗
PubMed1983

Inhalation of products of combustion.

The atmosphere of a fire is deadly to breathe. Firefighters or building occupants may be victims of the heat, irritating smoke, depleted oxygen, carbon monoxide, and such other toxic gases as cyanide, hydrogen chloride, and acrolein. Increasing numbers of homes and public buildings are being built and furnished with highly flammable synthetic materials that give off copious smoke and toxic gases when burned. Whether or not there are cutaneous burns, the possibility of inhalation injury must be considered in any fire victim. All victims of a fire environment should be presumed to have CO intoxication and should be treated with 100% oxygen until the HbCO level is within normal limits. In an extreme situation, cyanide intoxication should be suspected and administration of sodium thiosulfate may be lifesaving. Upper airway occlusion may result from thermal damage or edema secondary to burns from soluble toxic gases. Chemical injury to the lower airway and alveoli may result from inhalation of insoluble irritant gases and toxic gases adsorbed on carbon particles. Upper respiratory tract obstruction may be suggested by the clinical presentation (eg, pharyngeal burns, stridor, hoarseness, dysphagia), but only by means of fiberoptic bronchoscopy can it be recognized or excluded with certainty. Intubation may be necessary. Lower respiratory tract injury may be manifest clinically by dyspneas, wheezing and chest tightness, as well as by hypoxemia and reduced FEV1 and FVC. Treatment is symptomatic, but close observation for progressive respiratory insufficiency is necessary.

Arrhythmias, Cardiac↗
PubMed1988

Tracheitis: the 'other' cause of upper airway obstruction.

A 22-year-old woman presented to an ear, nose, and throat clinic with an upper respiratory infection and sudden stridorous respirations. Aerosolized isoethrane therapy was beneficial and fiber-optic nasolaryngoscopy revealed a normal supraglottis and purulent intratracheal secretions. Secretions were cultured and grew Staphylococcus aureus and alpha hemolytic Streptococcus. IV cefazolin was initiated and the patient recovered without sequelae. This case illustrates a rare cause of upper airway obstruction, tracheitis. Tracheitis has been found in the pediatric literature. This is the first adult case reported in the literature.

Adult↗
PubMed1994

Subglottic airway hemorrhage associated with idiopathic thrombocytopenic purpura.

A case of subglottic airway hemorrhage in a 6-year-old child with acute idiopathic thrombocytopenic purpura is presented. No previous cases have been reported in which idiopathic thrombocytopenic purpura was associated with this life-threatening complication. In this case, stridor responded to racemic epinephrine and oxygen. Emergency physicians and pediatricians should be aware of this rare complication.

Acute Disease↗