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Upper airway obstruction Diseases :lollipop: (:hibiscus:LaryngomalaciaâĶ
Upper airway obstruction Diseases
:lollipop:
Congenital malformation of Larynx
:hibiscus:Laryngomalacia
:star: M/C in
NB
Symptoms
Onset 2-3 wk
Sleep position âĻ
āļāļāļāļŦāļāļēāļĒ: āļāļēāļāļēāļĢāđāļĒāđāļĨāļ
āļāļāļāļāļ§āđāļģ/āļāļāļāļāļ°āđāļāļ: āļāļĩāļāļķāđāļ
Supraglottis floppy during Inspiration
Rx
āļŦāļēāļĒāđāļāļ
āļāļāļāđāļ (1-2 y/o)
Severe
âĻ Supraglottoplasty, Tracheostomy
:hibiscus: Subglottic stenosis
Acquired
subglottic stenosis
:earth_americas: Etio
ETT large size
High cuff pressure
Prolonged
intubation (>1 wk)
Laryngeal injury
High tracheostomy
Infection of trachea
Tumor
Thickening of cricoid
Dx
Film neck AP, Lateral + PE
Direct laryngoscopy
Fluoroscopy
CT/MRI
Rx
CO2 laser to :scissors: cut stenosis part
Severe âĻ Tracheostomy, Sx
Congenital
subglottic stenosis
Diameter of subglottis
Term: < 4 mm
Preterm: < 3.5 mm
Thickening of Cricoid
Assoc. symptoms
TE fistula
TVC paralysis
Down syndrome
Onset: 2-3 mo (infection)
Rx depends on
severity
Mild: Observe
Moderate: Tracheostomy
Severe: Laryngotracheoplasty, Cricoid split
Classification
Grade I: no obstruction to 50%
Grade II: 51 to 70%
Grade III: 71 to 99%
Grade IV: no detectable lumen
Mass
:hibiscus:Laryngocele
:hibiscus:Laryngeal hemangioma
:hibiscus:Vocal cord paralysis
Symptoms
(could be uni or bi)
Asso. with
Birth trauma
50% of kids got other
anomalies
PDA
Meningocele
Hydrocephalus
How many sides involve
Uni
lateral: Weak cry, Aspiration
Bi
lateral: Insp. Stridor, Aspiration
Treatment
Uni
lateral
70% āļŦāļēāļĒāđāļāļ 6 mo.
Food: Thickening of liquid diet
Speech Rx (āļāļķāļāļāļđāļ)
Bi
lateral
Tracheostomy
Arytenoidectomy (endoscopic/External)
:hibiscus:Recurrent laryngeal injury
Hx&PE
:star:Thyroidectomy (m/c)
Trauma fr ETT
Hoarseness, Aspiration, dyspnea
Rx depends on
uni/bilateral
and
clinical
:hibiscus:Acute supraglottitis (Epiglottitis)
VS
:hibiscus:Laryngeal injury
Mech:
Blunt 2. Penetrating injury
Clinical
Dyspnea
Dysphonia (āđāļŠāļĩāļĒāļāđāļāļĨāļĩāđāļĒāļ)
Bleeding, Hemoptysis
Subcutaneous emphysema
Inx
CT larynx
Rx
If Trauma âĻ ABCD + C-spine protection
:warning:
Avoid ETT
Tracheostomy
Sx (repair larynx)
:hibiscus:Laryngeal papilloma
Children > Adult : Juvenile laryngeal papilloma
Clinical: Dyspnea, Hoarseness
Related to HPV virus
Rx
CO2 laser
Tracheostomy if āļĢāļđāđāļāđāļĄāļŦāļĄāļ
:hibiscus:Laryngeal cancer