Most common cause of congenital stridor?
Ans. a (Laryngomalacia) (Ref PL Dhingra ENT 4th 1272)Laryngomalacia is the most common cause of airway obstruction in children and is the collapse of the supraglottis during inspiration. Laryngomalacia is usually a benign condition presenting soon after birth with resolution in the majority of cases by age two.Laryngomalacia / Congenital laryngeal stridor# Most common congenital abnormality of larynx# Excessive laxity of supraglottic larynx, which is sucked in during inspiration producing stridor.# Stridor is increased by crying and decreased by prone position.- Condition appears at birth and usually disappears by the age of 2 years or Symptoms usually appear at about 3 weeks of age and resolve spontaneously by 6-12 months.- The diagnosis is best made by direct laryngoscopy.- Laryngoscopy -Omega-shaped epiglottis, floppy aryepiglottic folds and prominent arytenoidsLaryngeal papillomasThese usually, although not always, precede the disease in the tracheobronchial tree and in the lungs. Therapeutic surgical manipulations, bronchoscopy, and tracheoscopy during the course of the disease induce its spread to the distal respiratory tree. Most commonly tracheobronchial papillomatosis is diagnosed before the age of 5 years.Recurrent Laryngeal Papillomatosis# Caused by HPV, which is a DNA virus .6# HPV 6 and HPV 11 are commonly implicated# Transmission to the neonate occurs secondary to direct contact with the Papillomatas in infected birth canal of the mother. 6Laryngeal web# Occurs due to incomplete recanalization of Larynx.# Characterized by membrane between anterior parts of vocal cord.# Airway obstruction# Weak cry# Treatment -excision of web by CO2-LASER/Knife. Laryngeal stenosis# Due to abnormal thickening or cricoid cartilage or fibrous tissue seen below the vocal cords.# Normal cry# Diagnostic criteria -Subglottic diameter < 4 mm (full term)# <3 mm (premature).Subglottic hemangioma# Though congenital, hemangioma manifests at 3-6 months of age when it begins to increase in size.# 50% of children are associated with cutaneous hemangiomas.# Clinical features -stridor, but cry is normal.# Reddish mass on laryngoscopy in subglottic region.# Treatment --tracheostomy and observation (as many hemangiomas involute spontaneously), steroid therapy and CO2 Laser excision.Larvngofissure Q is opening the larynx in midline
Laryngomalacia
Laryngeal web
Laryngeal papillomatosis
Tracheomalacia
Larynx