Title:
Management of stridor in neonates and infants
Authors:
J. Claes*, A. Boudewyns*, P. Deron**, V. Vander Poorten***, H. Hoeve****
Institutions:
*Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital; **Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Free University Hospital, Brussels; ***Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven; ****Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Sophia Children’s’ Hospital, Rotterdam, The Netherlands
Keywords:
Guidelines, stridor, neonates and infants, treatment
Pages:
113 - 125
Abstract:
Stridor is the sound caused by abnormal air passage into the lungs and can exist in different degrees and be caused by obstruction located anywhere in the extra-thoracic (nose, pharynx, larynx, trachea) or intra-thoracic airway (tracheobronchial tree). Stridor may be congenital or acquired, acute, intermittent or chronic. Laryngotracheal inflam- mation (croup) is the most common cause of acute stridor. Laryngotracheomalacia is the most common cause of con- genital, chronic stridor. Stridor is a clinical sign and not a diagnosis. The golden standard in the workup of stridor is an upper and lower airway endoscopy under general anaesthesia. Endoscopic examination under general anaesthesia requires a multidisciplinary approach and close cooperation between anaesthesiologist, paediatrician, ENT surgeon and nursing staff. Following this procedure, a place in the intensive care unit should be available for those cases presenting with stridor in which a defi- nite diagnosis could not yet be established. Although important, pre-endoscopy assessment including history, physical examination and radiological examination, is only a guide to the type and degree of pathology found during endoscopy.About 1 out of 10 infants are found to have lesions in more than one anatomical site of the upper aerodigestive tract.
Issue:
Suppl. 1, 2005


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Management of stridor in neonates and infants