Chronic pediatric stridor: etiology and outcome

Area of Science:

• Pediatric Otolaryngology
• Pediatric Pulmonology
• Pediatric Airway Disorders

Background:

• Stridor in children is typically an acute condition.
• Chronic pediatric stridor is less common but presents unique diagnostic challenges.
• Understanding the etiology and progression of chronic stridor is crucial for effective management.

Purpose of the Study:

• To review the characteristics of chronic pediatric stridor.
• To identify common causes and associated factors.
• To assess the need for airway intervention and long-term outcomes.

Main Methods:

• Retrospective chart review and telephone survey of 60 pediatric patients with chronic stridor.
• Analysis of etiological factors, need for intervention, symptom duration, and presence of multiple lesions.
• Correlation of clinical signs, such as cyanosis, with lesion complexity.

Main Results:

• Laryngomalacia was the most frequent cause of chronic stridor.
• Airway intervention was necessary in 22% of cases.
• Symptoms persisted beyond 18 months in 17% of patients.
• Twelve percent of patients had multiple lesions, with 65% of secondary lesions located below the vocal cords.
• Cyanosis was associated with a higher likelihood of multiple lesions.
• No increased risk of recurrent upper respiratory infections was observed.

Conclusions:

• Laryngomalacia is a primary cause of chronic pediatric stridor.
• Chronic stridor may necessitate intervention and can persist beyond infancy.
• Physicians should consider the possibility of multiple airway lesions in the presence of cyanosis.
• Chronic stridor does not appear to predispose children to recurrent respiratory infections.