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At least 91 records · Page 5Linked to original sources

PubMed1990

Nocturnal stridor in olivopontocerebellar atrophy.

We describe a patient with olivopontocerebellar atrophy (OPCA) who was referred for alleged "snoring." Polysomnogram with video and audio monitoring revealed that the patient actually had nocturnal stridor causing repetitive oxygen desaturations. Direct laryngoscopy while awake showed a unilateral vocal cord paralysis. The nocturnal stridor persisted after unilateral vocal cord pinning, suggesting that the patient had probably been experiencing bilateral vocal cord paresis while asleep. We conclude that state-dependent vocal cord dysfunction may be severe in OPCA and related multiple system atrophy. Nocturnal stridor has many causes and may mimic snoring and obstructive sleep apnea syndrome. Polysomnography with audio and video recordings are necessary to make the diagnosis.

Arousal↗

PubMedDate not supplied

Treatment of postextubation stridor in a pediatric patient with burns: the role of heliox.

Stridor is a common problem in patients with burns after extubation, especially in children and in those with facial burns or airway injuries. The usual treatments for severe respiratory distress, such as reintubation and tracheotomy, carry substantial risks for patients. We report our successful treatment of severe postextubation stridor in a 7-year-old patient with burns with the administration of heliox in addition to more traditional therapies, review the literature about the use of heliox in postextubation stridor, and suggest cases in which its use may prevent the need for more hazardous interventions.

Burns↗

PubMed1990

The child with simultaneous stridor and wheezing.

We describe 25 patients with simultaneous stridor and wheezing. Twelve patients presented to the emergency department of The Children's Hospital of Denver over a two-year period; we found an additional 13 in a review of the literature. A combination of two disorders produced stridor and wheezing in six patients, with one condition in the extrathoracic airway and one in the intrathoracic airway. The remaining 19 patients had single lesions, nine with obstruction of the extrathoracic airway and 10 with obstruction of the intrathoracic airway. The causes of stridor and wheezing in these 19 patients fell into three general categories: (1) congenital lesion affecting the airway (eight patients); (2) foreign body in the airway or esophagus (nine patients); and (3) acquired lesion affecting the airway (two patients). All eight patients with congenital lesions developed symptoms by four months of age. All nine patients with an airway or esophageal foreign body were between five and 30 months of age. The history may be misleading, and the physical examination often cannot discriminate among the various likely diagnoses. However, the addition of four plain x-ray views (lateral neck, posteroanterior and lateral chest, and forced expiratory chest) located the site of obstruction in 18 of 25 patients. Barium swallow identified the two patients with vascular rings. Four patients underwent endoscopy to determine the site of obstruction. We make recommendations for evaluation of these patients.

Adolescent↗

PubMed2000

[Cytomegalovirus (CMV) infection in infants may result intractable stridor].

We found ten cases of human cytomegalovirus (CMV) infection who were intractable stridor. Their symptoms were not improved by the treatment with aminophyllin nor beta stimulants. They were admitted repeatedly complaining of stridor, fever and diarrhea. In two cases, the immunological findings showed a decrease of bacterial sterilizing activity of the neutrophils. Additionally, blood count showed leukocytosis more than 15,000/ul in all cases. Total serum IgE and specific IgE antibodies to many antigens were not elevated. Transaminase was elevated. Chest X-p findings of interstitial pneumonia or atelectasis continued for a long time in some cases. Virological examinations revealed high concentrations of specific IgM or CF antibodies against CMV in all cases. CMV DNA in saliva were examined by polymerase chain reaction (PCR) with primer sets for the immediate early (IE) region of CMV and showed positive in seven cases. CMV in bronchoalveolar lavage (BAL) was isolated in two cases, and CMV PCR in BAL was positive in three cases. The sequence of the CMV-PCR products showed almost same sequence except one point mutation in bp 1203. We considered that CMV infections in infants may induce stridor for a long period.

Cytomegalovirus Infections↗

PubMed1986

Sleep apnoea in infants with congenital stridor.

Indices of central apnoea, respiration rate, heart rate, and body movements were comparable in seven infants with congenital stridor (infantile larynx) and matched controls. Obstructive sleep apnoea was only observed in three of seven infants with stridor. Periodic breathing was less common in infants with stridor than in controls.

Female↗

PubMed1997

Psychogenic stridor: diagnosis and management.

Psychogenic stridor is a rare cause of apparent acute upper airway obstruction, usually occurring in young female adults. The alarming presence of inspiratory stridor leads to suspicion of organic disease, with urgent management directed towards treatment of suspected pathology. Careful history taking may suggest the correct diagnosis and early examination of the larynx, preferably by fibreoptic nasendoscopic examination, may identify the underlying abnormality of paradoxical adduction of the vocal cords on inspiration, accounting for the stridor. This characteristic feature allows a positive diagnosis to be made and may avoid potentially harmful and inappropriate interventions. Three cases are presented, illustrating an evolution of management.

Adolescent↗

PubMed2004

The effects of chin lift and jaw thrust while in the lateral position on stridor score in anesthetized children with adenotonsillar hypertrophy.

Obstruction of the upper airway is a major challenge for anesthesiologists administering general anesthesia in spontaneously breathing patients, especially in pediatric anesthesia with adenotonsillar hypertrophy. Lateral positioning is a simple treatment for obstructive sleep apnea and also decreases collapsibility of the pharynx in anesthetized adults with obstructive sleep apnea. In this study, we examined the effects of body position shifting and common airway maneuvers, such as chin lift and jaw thrust, on airway patency (stridor score) in anesthetized children scheduled for adenotonsillectomy. Thirty children aged 1-10 yr were anesthetized with sevoflurane. During spontaneous breathing of 5% sevoflurane, stridor score was recorded. After baseline recording, chin lift and jaw thrust were performed on patients in both the supine and the lateral decubitus positions. Chin lift and jaw thrust improved the stridor score. Furthermore, lateral positioning dramatically enhanced the effects of these airway maneuvers on airway patency. Jaw thrust combined with lateral positioning provided easy airway management for the anesthesiologists. We conclude that lateral positioning combined with airway maneuvers significantly improved airway patency compared with the airway maneuvers alone for patients in the supine position.

Adenoidectomy↗

PubMed1993

Case report: lingual thyroid, a cause of neonatal stridor.

Stridor implies partial airway obstruction, resulting from intrinsic or extrinsic abnormalities of the upper respiratory tract. In a neonate whose airway is small, soft and easily occluded this may be potentially life threatening. Its immediate diagnosis with prompt therapy is a rewarding challenge. When stridor occurs in a neonate with congenital hypothyroidism, surgically amenable cause of obstruction due to an ectopic thyroid or thyroglossal cyst has to be seriously considered. We report a case of neonatal stridor caused by a lingual thyroid, and discuss the imaging approach.

Congenital Hypothyroidism↗

PubMed1983

Gastroesophageal reflux causing stridor.

We describe an infant with stridor associated with gastroesophageal reflux (GER). This is the first report in which there is clear documentation by pH probe of a temporal association between individual episodes of GER and stridor. We review the literature and speculate on the relationship between these two phenomena. GER should be considered in patients with stridor.

Bethanechol Compounds↗

PubMedDate not supplied

Laryngeal papilloma presenting as steroid-dependent asthma in a 3-year-old child without recurrent stridor.

Upper airway obstruction is well described as a cause of apparent asthma. However, it can be very difficult to diagnose in young children. This 3-year-old male presented with a 1-year history of severe recurrent wheezing with six emergency room visits in the previous 5 months. Cromolyn, inhaled corticosteroids, and frequent predinisolone bursts had not controlled the wheezing. There was no history of barky cough, croup, or stridor. His physical examination was notable for marked nasal obstruction. At initial presentation, his lungs were normal with no wheezing or stridor. Soft tissue neck X-ray films suggested the presence of a subglottic mass. A large solitary papilloma was found on bronchoscopy. After surgical removal, there was no further wheezing noted by either the parents or his physicians. Laryngeal papillomatosis may mimic asthma in the absence of symptoms of hoarseness, croup, or stridor. It should be particularly considered in 2 to 4-year-old children with recurrent wheezing that is poorly responsive to aggressive therapy including oral corticosteroids.

Airway Obstruction↗

PubMed2004

[Congenital laryngeal stridor].

We reviewed the diagnosis, complications and treatment of congenital laryngeal stridor (CLS), in 97 patients who consulted our clinic between 1991 and 2001. The 97 patients were diagnosed with laryngeal malacia (32%), vocal cord paralysis and laryngeal stenosis (22%), a neoplastic disease like hemagioma and papilloma (11%), or cystic disease (7%). The cases with vocal cord paralysis, laryngeal stenosis or laryngeal cysts were usually diagnosed within 2 months of birth based on severe dyspnea. Two of the 31 cases of laryngeal malacia and 2 of the 22 cases of vocal cord paralysis were associated with neuromuscular disorders. Three patients suffered from vocal cord paralysis complicated by laryngeal stenosis. Thirty-three of the 97 cases required a tracheostomy; these 33 cases included the one case of laryngeal papilloma (100%), 9 of the 10 cases of hemangioma (90%), and 18 of the 24 cases of laryngeal stenosis (75%). Since any disorders of the upper airway can potentially induce stridor, establishing an accurate diagnosis is sometimes difficult when stridor is the only presenting symptom. Hence, information on associated symptoms and the past history of the subject is particularly important for an accurate diagnosis. In addition, decisions regarding the course of treatment course require adequate consideration of possible complications.

Dyspnea↗

PubMed1999

Investigation and treatment of chronic stridor in infancy.

Stridor is relatively common in infants, in whom any inflammation of the small, anteriorly placed, neurologically immature upper airway can lead to significant airflow obstruction. Persistent stridor is most commonly due to laryngomalacia but may be due to a range of other structural abnormalities. A clinical diagnosis can often be made based on age, associated symptoms and the nature of the stridor. With the exception of classical mild laryngomalacia, diagnosis is confirmed by endoscopy and/or imaging. With collaboration between all health practitioners involved, the correct diagnosis and appropriate treatment can be provided.

Diagnosis, Differential↗

PubMed2003

Hysterical stridor: a report of two cases.

Stridor as an initial symptom of a conversion reaction (hysteria) is rare. We report cases of hysterical stridor in two older women, unrelated and unacquainted, from the same rural community in Oman. Once the diagnosis was made, both patients were successfully treated with a single dose of an anxiolytic. We also review the literature on hysterical stridor and discuss the diagnostic dilemmas and therapeutic options.

Anti-Anxiety Agents↗

PubMed2003

[Anesthesia and fibrobronchoscopy for the study of chronic stridor in a boy with Robinow syndrome].

Robinow's syndrome involves fetal facial features, short stature, brachymelia, hypoplastic genitals and a normal karyotype. A 10-year-old boy with Robinow's syndrome was scheduled for study of chronic stridor by fiberoptic bronchoscopy. Airway exploration with the patient awake revealed hipertelorism, retromicrognathia, poor dental alignment, macroglossia and class IV Mallampati. After anesthetic induction in spontaneous ventilation with 5% sevoflurane, grade IV Cormack-Lehane conditions were observed. A laryngeal mask was placed without muscle relaxation after which the boy was ventilated manually for several minutes without stridor. Anesthetic maintenance was with 3% sevoflurane in 50% oxygen and air. After recovery of spontaneous ventilation, marked stridor presented along with a decrease in oxygen saturation and expired fractions of sevoflurane and CO2. Pulse oxymetry did not increase with increased FiO2. However, when continuous positive airway pressure (CPAP) was set al 10 cm H2O, pulse oxymetry did increase; likewise, expired and inspired sevoflurane concentrations became equal, and expired CO2 increased. Fiberoptic bronchoscopy revealed an area of intrathoracic tracheomalacia, which collapsed partially during spontaneous expiration and collapsed less when CPAP was started. We discuss the relation between the facial dysmorphia characteristic of this syndrome and the possibility of finding a difficult airway, as well as the diagnosis and treatment of intrathoracic tracheomalacia during anesthesia.

Abnormalities, Multiple↗

PubMed1992

Respiratory stridor associated with polymyopathy suspected to be hyperkalemic periodic paralysis in four quarter horse foals.

Four Quarter Horse foals ranging in age from 6 days to 2 months were determined to have upper airway stridor secondary to polymyopathy suspected to be hyperkalemic periodic paralysis. Electromyography revealed spontaneous muscle activity in all muscles examined. Electromyographic findings were similar in the dams of 3 foals (No. 1, 3 and 4). Hyperkalemia was found in foals 1 and 4. Endoscopically, the upper airway stridor in foals 1 and 3 was confirmed to be attributable to laryngeal and pharyngeal collapse or spasm. Foals 1, 2, and 3 were treated with acetazolamide. Foal 4 was not treated, at the owner's request. Foals 2 and 3 improved with treatment, foal 4's condition was static, and foal 1 required a tracheostomy and laryngeal surgery to manage its upper airway stridor.

Acetazolamide↗

PubMedDate not supplied

Saccular cyst in an infant: an unusual cause of life-threatening stridor and its surgical treatment.

Saccular cysts in infants are rare lesions of the larynx and may result in respiratory obstruction and severe dyspnea. Herein we present a case of saccular cyst in a three-month-old infant. She was presented with severe stridor and respiratory distress. She had been followed with the diagnosis of tracheomalacia for three months elsewhere. Direct laryngoscopy of the larynx revealed a saccular cyst. Stridor disappeared shortly after surgical excision of the supraglottic saccular cyst under direct laryngoscopy. No complication or recurrence was seen in the 12-month follow-up period. Saccular cysts in infants are rare lesions and should be kept in mind in the differential diagnosis of stridor in infants.

Airway Obstruction↗

PubMed1990

[An unusual cause of laryngeal stridor: the Shy-Drager syndrome].

A case of laryngeal stridor in an adult patient is presented and the diagnose of syndrome of Shy-Drager is proposed. This syndrome is the result of a degeneration of the central nervous system. Some autonomic functions are involved in this process. The leading symptoms are an orthostatic hypotension, parkinson-like symptoms and laryngeal stridor. The last symptom results from a neurogenic paralysis of both posterior crico-arytenoideus muscles. A depletion of neurotransmitters in the central nervous system would be the cause of the syndrome. The treatment is symptomatic. Concerning the laryngeal stridor, tracheotomy, eventually followed by a crico-arytenoidopexy, is the only treatment which can be proposed.

Aged↗

PubMedDate not supplied

[Neonatal stridor. Description of a case of double aortic arch].

Neonatal stridor often relates with a serious respiratory distress. We report a case of stridor appeared in tenth day of life. In this case of double aortic arch the surgical intervention at 25 days had a favourable outcome. Three months later the child was completely asymptomatic. An early diagnosis allows a prompt surgical approach with a favourable outcome. We outline the diagnostic procedure in neonatal stridor.

Aorta, Thoracic↗