Stridor causes, epiglottitis, laryngomalacia, vocal cord paralysis, tonsillectomy indications, obstructive sleep apnea and pediatric foreign bodies.
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- What is stridor?
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A high-pitched, harsh sound caused by turbulent airflow through a narrowed airway.- What level of airway obstruction does inspiratory stridor usually indicate?
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Obstruction above or at the glottis (supraglottic or extrathoracic).- What level of airway obstruction does expiratory stridor usually indicate?
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Obstruction below the thoracic inlet (intrathoracic airway).- What level of airway obstruction does biphasic stridor usually indicate?
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A fixed obstruction at the glottis or subglottis.- What is the most common congenital cause of stridor in infants?
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Laryngomalacia.- What organism most commonly causes croup (laryngotracheobronchitis)?
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Parainfluenza virus.- What organism historically caused most cases of acute epiglottitis in children?
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Haemophilus influenzae type b.- What classic finding is seen on a lateral neck x-ray in epiglottitis?
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The thumbprint sign, a swollen, rounded epiglottis.- How does the speed of onset differ between epiglottitis and croup?
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Epiglottitis progresses rapidly over hours; croup develops more gradually over a day or two.- What position do children with epiglottitis often adopt for comfort?
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The tripod position: sitting forward, chin extended, mouth open.- Why should a tongue depressor exam of the oropharynx be avoided in suspected epiglottitis?
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It can trigger laryngospasm and sudden complete airway obstruction.- In suspected epiglottitis, where should the airway be secured?
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In a controlled setting such as the operating room, with anesthesia and ENT present.- What is the underlying pathophysiology of laryngomalacia?
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Collapse of flaccid supraglottic structures (epiglottis and arytenoid cartilages) into the airway during inspiration.- At what age does laryngomalacia stridor typically peak, and when does it usually resolve?
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Peaks around 4 to 8 months; usually resolves by 18 to 24 months.- How is laryngomalacia definitively diagnosed?
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Awake flexible laryngoscopy showing supraglottic collapse on inspiration.
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