Revista chilena de pediatría
versión impresa ISSN 0370-4106
ALVAREZ G., Cecilia et al. Unusual causes of stridor in newborns: a description of 3 cases. Rev. chil. pediatr. [online]. 2002, vol.73, n.2, pp. 152-158. ISSN 0370-4106. http://dx.doi.org/10.4067/S0370-41062002000200007.
Stridor is a sign of upper airway obstruction at the supraglottic, glottic or subglottic level. 60% of cases in infants are due to laryngomalacia. There are other aetiologies that despite being infrequent are potentially life threatening. A high index of suspicion is needed for an early diagnosis in these cases. In this article we review the diagnosis and treatment of 3 different cases of stridor which occurred during the first month of life. Case 1: full term infant with velocardiofacial syndrome, 22q11 deletion, who developed stridor, dysphonia, respiratory distress and cyanosis in the first 48 hours of life. A flexible bronchoscopy was performed at day 14 revealing a type II laringeal web. Case 2: preterm infant who developed at 1 month progressive respiratory distress and stridor, laryngoscopy at 45 days revealed a subglottic haemangioma. While being on steroids the patient developed Cushing syndrome with no significant improvement of the stridor, a flexible broncoscopy at 2 months 24 days showed a subglottic haemangioma that occluded 50% of the airway lumen with no other abnormalities. Case 3: fullterm infant who developed stridor on the third day. Laryngoscopy at 2 months showed laringomalacia. At 7 months the patient developed cyanotic spells, apnoea and worsening of the stridor. Flexible bronchoscopy showed an extrinsic anterior compression of the lower third of the trachea. Oesophagogram and MRI were diagnostic of a vascular ring (double aortic arch). We stress the importance of an early specific diagnosis of the cases of stridor with respiratory distress, cyanotic spells, apnoea or dysphonia. Flexible bronchoscopy is an extremely useful procedure that permits the visualization of the upper and lower airway. It is always important to rule out lower airways lesions that could be associated with larygnomalacia
Palabras clave : flexible bronchoscopy; stridor; infants.