الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 117 |  |  |
| | | from | 117 | | |
Abstract
There are various aetiologies of stridor in paediatric patients that may be acute or chronic, congenital or acquired, intrathoracic or extrathoracic. The incidence of stridor in the general paediatric population is unknown. Careful and detailed history taking and clinical examination would help to assess the severity of the illness and to decide whether immediate intervention is necessary. So, the present study cross sectional study was carried out to assess aetiological profile of pediatric stridor in Mansoura University Hospital, Dakahlia Governorate. It was carried out on 181 children attending inpatient and outpatient clinics of Otolaryngology department. As regards sociodemographic characteristics, our patients had a median age of 6 months ranging from 1 month to 48 months, with 60.2% are males, 65.7% live in rural areas, 60.8% of their mothers are not working and 100% of their fathers are working. In the current study, the median age of disease onset was 4 weeks ranging from 1 week to 3 years, 81.2% have stridor with supine position, 17.1% have weak crying, 50.8% have sore throat and nasal congestion. Among studied children, 22.1% have stridor at awake, 2.2% have hyperextension of the neck , 5% have difficulty in speaking and 17.7%have history of fever. In addition, 23.2% have braking cough and 5.5% have brassy cough. History of wheezing or snoring, drooling of saliva, have stridor at sleep and difficulty in swallowing are found among (18.8 %, 1.7%, 94.5% and 24.9%, respectively). In our study patients, 1.7% of the studied children had positive history of asthma and 1.1% had positive history of allergy. On chest examination, 68% of our study patients had supraclavicular muscle retraction by inspection and 9.9% had abnormal nasal flaring. By auscultation; chest of the studied children includes 81.8% with inspiratory stridor, 14.4% with biphasic and 3.9% with expiratory stridor. Decreased air entry is detected among 19.3% of the studied children. In term of aetiology, our study found that 67.4% of the current study patients had congenital laryngomalacia, 13.8% had croup, 4.4% had laryngeal web, 3.3% had congenital bilateral vocal cord paralysis and the least frequent cases were epiglottitis, vascular slings, anaphylaxis, tracheomalacia. In our study, 22.1% of the studied children have eating or feeding difficulties. Progression to obstruction was detected among 21.5% of the studied children in the current study. Sleep obstruction so severe that sleep is disturbed are detected among 21.0% of the studied children. Cyanotic episodes are detected among 17.1% of the studied children. In conclusion, stridor must be recognised as a symptom of upper airway obstruction, which can range from minimal to life threatening in severity. It is essential to establish the correct diagnosis for optimal management. Laryngomalacia was the commonest congenital cause of paediatric stridor referred to the Otolaryngology in Mans0ura University H0spital. Diagnosis should be made earlier and effective management should be given.