Page 1029 - TNFlipTest

Toronto Notes 2019 Pediatric Otolaryngology Otolaryngology OT43
• laryngeal
■ laryngomalacia: most common cause of stridor in children
■ vocal cord palsy (due to trauma or Arnold-Chiari malformation) ■ glottic web
■ subglottic stenosis
■ laryngeal cleft
■ laryngocele
• tracheal
■ tracheoesophageal fistula ■ tracheomalacia
■ vascular rings
■ complete tracheal rings
2-3 Months
• congenital
■ laryngomalacia
■ vascular: subglottic hemangioma (more common), innominate artery compression, double aortic
arch
■ laryngeal papilloma
• acquired
■ subglottic stenosis: post-intubation
■ tracheal granulation: post-intubation
■ tracheomalacia: post-tracheotomy and TEF repair
Infants – Sudden Onset
• foreignbodyaspiration • croup
• bacterialtracheitis
• causticingestion
• epiglottitis
Children and Adults
• infection
■ Ludwig’s angina
■ peritonsillar/parapharyngeal abscess ■ retropharyngeal abscess
• neoplastic
■ squamous cell carcinoma (larynx, hypopharynx (adults)) ■ retropharyngeal: lymphoma, neuroblastoma
■ nasopharyngeal: carcinoma, rhabdomyosarcoma
• allergic
■ angioneurotic edema
■ polyps (suspect cystic fibrosis in children)
• trauma
■ laryngeal fracture, facial fracture ■ burns and lacerations
■ post-intubation
■ caustic ingestion
• congenital
■ lingual thyroglossal duct cyst ■ lingual tonsil hypertrophy
■ lingual thyroid
Signs of Airway Obstruction
Stridor
• notequality,timing(inspiratoryorexpiratory) • bodypositionimportant
■ lying prone: double aortic arch
■ lying supine: laryngomalacia, glossoptosis • siteofstenosis
■ vocal cords or above: inspiratory stridor
■ subglottis and extrathoracic trachea: biphasic stridor ■ distal tracheobronchial tree: expiratory stridor
Respiratory Distress
• nasalflaring
• supraclavicularandintercostalindrawing • sternalretractions
• useofaccessorymusclesofrespiration
• tachypnea
• cyanosis
• alteredLOC