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Recurrent stridor in an infant

Chien Ying Vincent Ngu1, Jeyasakthy Saniasiaya2, Jeyanthi Kulasegarah1

  • 1Department of Otorhinolaryngology, University of Malaya, Faculty of Medicine, Kuala Lumpur, WP Kuala Lumpur, Malaysia.

BMJ Case Reports
|September 8, 2021
PubMed

Insights

Bilateral vocal cord palsy in infants can cause emergency airway obstruction. Promptly identifying Arnold Chiari II malformation as the cause allowed for hydrocephalus treatment, resolving stridor without tracheostomy.

Area of Science:

  • Pediatric Pulmonology
  • Pediatric Neurology
  • Pediatric Otolaryngology

Background:

  • Paediatric upper airway obstruction is a critical medical emergency.
  • Bilateral vocal cord palsy is an uncommon cause of paediatric airway obstruction.
  • Thorough investigation is essential to determine the underlying etiology of vocal cord palsy.

Observation:

  • A 4-month-old infant presented with recurrent inspiratory stridor.
  • The infant was diagnosed with bilateral vocal cord palsy secondary to Arnold Chiari II malformation.
  • Arnold Chiari II malformation was associated with hydrocephalus.

Findings:

  • Immediate intervention to drain hydrocephalus was performed.
  • The infant experienced complete resolution of inspiratory stridor post-intervention.
  • Tracheostomy was successfully avoided.

Implications:

  • This case underscores the importance of comprehensive diagnostic evaluation in paediatric airway emergencies.
  • Non-invasive management of hydrocephalus resolved vocal cord palsy symptoms, avoiding tracheostomy.
  • Avoiding tracheostomy preserves speech, swallowing function, and quality of life in affected children.

Keywords:
congenital disordersearnose and throat/otolaryngologypaediatrics

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