1/52. Neonatal stridor in association with herpes simplex infection of the larynx.herpes simplex virus (HSV) infection in the neonatal period may be confined to the eyes, skin and upper aerodigestive tract or may be widely disseminated to other organs, with particular recognition of involvement of the central nervous system (CNS) causing herpes encephalitis (Whitley et al., 1980a, b; Andersen, 1987). Primary laryngeal HSV infection is extremely uncommon. We present a case of acute neonatal stridor secondary to such localized disease and discuss its management.- - - - - - - - - - ranking = 1keywords = larynx (Clic here for more details about this article) |
2/52. An unusual case of stridor due to osteophytes of the cervical spine: (Forestier's disease).Stridor is a noisy breathing caused by compromised airway in the larynx and trachea. The causes can either be due to intrinsic or extrinsic compression. Stridor resulting from extrinsic compression due to anterior cervical osteophytes is rare. We report an unusual case of acute stridor due to an osteophytic mass in the cervical vertebrae resulting in a mechanical upper airway obstruction. The underlying pathology was Forestier's disease or diffuse idiopathic skeletal hyperostosis (DISH). Stridor is a rare manifestation of DISH and it certainly represents the most life-threatening one. Only a few cases have been reported in the English literature and are mainly secondary to impaired function of the vocal folds, or postcricoid ulceration and oedema. We present such a case, in that stridor was the result of direct airway obstruction by the osteophytic mass and an emergency tracheostomy had to be performed to establish an airway.- - - - - - - - - - ranking = 0.25keywords = larynx (Clic here for more details about this article) |
3/52. Vallecular cyst: report of four cases--one with co-existing laryngomalacia.Congenital vallecular cysts are rare. In this report, four infants having vallecular cysts encountered over a six-year period from 1992 to 1997 were reviewed. All of them presented with upper aerodigestive tract symptoms. Marsupialization was performed in three of them and CO2 laser excision was performed in the fourth patient. There was no recurrence of the cyst in any patient. One of them also had co-existing laryngomalacia. The degree of airway collapse caused by laryngomalacia improved after cyst removal. The laryngomalacia resolved spontaneously. cyst fluid culture was performed in one of the patients and yielded staphylococcus aureus but there was no other definite indicator of infection. staphylococcus aureus could also be isolated in the respiratory tract from two of the other patients.- - - - - - - - - - ranking = 2424.1012345509keywords = laryngomalacia (Clic here for more details about this article) |
4/52. Tardive dystonia of the larynx in a quadriplegic patient: an unusual cause of stridor.We describe a case of a quadriplegic brain-damaged man with severe upper airway obstruction. A diagnosis of tardive dystonia affecting the vocal folds was made and confirmed by flexible nasopharyngoscopy. Emergency tracheotomy was required. The tardive movement disorder resolved with discontinuation of thioridazine. This case serves to heighten awareness of potentially serious airway complications associated with the use of anti-psychotics and anti-emetics particularly in those with organic brain disease.- - - - - - - - - - ranking = 1keywords = larynx (Clic here for more details about this article) |
5/52. An unusual case of stridor after thyroidectomy.Twelve days after subtotal thyroidectomy, an air pocket developed in a patient's neck. The pressure in this pocket had gradually increased as small amounts of air, probably associated with coughing, came out of a tiny hole in the trachea to form a pneumocoele. This produced limited surgical emphysema, causing venous congestion and oedema of the soft tissues of the larynx, which in turn led to increasing airway obstruction. We believe that this is the first reported case of a pneumocoele that gradually increased in size, causing airway obstruction that was almost certainly due to secondary laryngeal oedema.- - - - - - - - - - ranking = 0.25keywords = larynx (Clic here for more details about this article) |
6/52. adult laryngomalacia: an uncommon clinical entity.A 27-year-old female presented with a several-day history of acute onset inspiratory stridor and shortness of breath that worsened with phonation and minimal exertion. Flexible fiberoptic direct laryngoscopy revealed prolapse of the mucosa overlying the arytenoid cartilages bilaterally, consistent with type 1 laryngomalacia. These symptoms persisted with only minimal improvement despite administration of short-term corticosteroids, several weeks of antireflux medications, and other conservative measures. The patient underwent a supraglottoplasty and exhibited a marked improvement in her symptoms. The literature describes several cases of exercise-induced laryngomalacia in both pediatric and adult populations in which symptoms of inspiratory stridor and shortness of breath are induced by exercise but resolve upon its discontinuation. adult laryngomalacia appears to be a clinical entity distinct from exercise-induced laryngomalacia because symptoms fail to resolve after several weeks of medical therapy and discontinuation of exertional activity. This case suggests that adult laryngomalacia, unlike pediatric and exercise-induced laryngomalacia, is less likely to resolve over time with conservative management and may require surgical intervention with supraglottoplasty necessary to alleviate symptoms.- - - - - - - - - - ranking = 3463.0017636441keywords = laryngomalacia (Clic here for more details about this article) |
7/52. Double trouble: prolapsing epiglottis and unexpected dual pathology in an infant.A 3-week-old full-term female neonate was admitted with a 4-day history of episodic stridor, desaturations and difficult feeding. Initial assessment using fluoroscopy suggested distal tracheomalacia. Inhalational induction for examination under anaesthesia of the upper airway at 4 weeks of age caused almost complete airway obstruction due to severe anterior, or epiglottic, laryngomalacia. This airway obstruction was unresponsive to continuous positive airway pressure, the use of an oropharyngeal airway and hand ventilation and required urgent tracheal intubation using suxamethonium. Epiglottopexy, a relatively unknown procedure, was performed uneventfully 2 days later, with complete relief of the respiratory compromise. However, the infant remained desaturated postoperatively. A ventilation perfusion scan subsequently revealed multiple pulmonary arteriovenous malformations, unsuitable for embolization and requiring nocturnal home oxygen therapy. review at 3 months of age found a thriving infant with no airway obstruction and good epiglottic positioning on examination under anaesthesia. Although the patient's oxygen requirements had diminished, the long-term outcome remains uncertain.- - - - - - - - - - ranking = 346.30017636441keywords = laryngomalacia (Clic here for more details about this article) |
8/52. Laryngeal sporotrichosis causing stridor in a young child.Fungal infections of the larynx are rare entities that must be considered in the differential diagnosis of the patient who presents with laryngeal symptoms. We present an unusual case of initially recurrent and then persistent stridor in a 19-month-old girl, unresponsive to 4 months of antibiotic and steroid therapy. Upon our laryngoscopic examination, the patient was noted to have an ulcerated, granulomatous process involving the larynx. She also had an erythematous papule on the left thigh. Fungal cultures of both sites grew sporothrix schenckii. The patient was treated with systemic antifungal medications and had complete resolution of her symptoms. We discuss the pathophysiology and possible source of this unusual form of sporotrichosis, the first such case reported in a child. We emphasize the role of empiric steroid therapy in exacerbating and eventually enabling dissemination of the infection. We also review the manifestations of sporotrichosis infections of the head and neck. This case demonstrates the vital importance of careful diagnosis and proper treatment of stridor in children.- - - - - - - - - - ranking = 0.5keywords = larynx (Clic here for more details about this article) |
9/52. laryngomalacia induced by exercise in a pediatric patient.exercise-induced laryngomalacia (EIL) is characterized by inspiratory stridor that is brought on by exercise (i.e. competitive sports) and fails to respond to treatment with bronchodilators (Smith et al., Ann Otol Rhinol Laryngol 1995;104:537-541). During exercise, (1) spirometric flow volume loops show evidence of variable extrathoracic obstruction, and (2) laryngoscopy shows inspiratory prolapse of supraglottic structures with partial glottic obstruction. Only five cases of probable EIL have been reported in the literature (Smith et al., Ann Otol Rhinol Laryngol 1995;104:537-541; Lakin et al., Chest 1984;86:499-501; Bittleman et al., Chest 1994;106:615-616; Bent et al., Ann Otol Rhinol Laryngol 1996;105:169-175; Chemery et al., Rev Mal Respir 2002;19:641-643). Here, a case of laryngomalacia induced by exercise in a previously asymptomatic 10-year-old athlete with a remote history of laryngomalacia in infancy is presented, and a review of previously reported cases is provided.- - - - - - - - - - ranking = 1038.9005290932keywords = laryngomalacia (Clic here for more details about this article) |
10/52. Laryngeal lymphatic malformation in a newborn.Stridor in a neonate evokes a series of prompt evaluations to determine the etiology. Common etiologies include inherent structural defects (such as laryngomalacia), vocal fold paralysis, acquired infectious etiologies, or extrinsic compressions. We report a neonate with a lymphatic malformation (lymphangioma) initially confined to the larynx that presented with stridor and progressive respiratory failure. Only seven other cases have been reported to present with lymphatic malformation confined solely to the larynx. There are several different modalities available to treat this condition, but recurrences are common. The presentation and management are discussed below. physicians should be aware that stridor in a neonate can result from this unusual intrinsic obstruction of the larynx.- - - - - - - - - - ranking = 347.05017636441keywords = laryngomalacia, larynx (Clic here for more details about this article) |
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