13.03.01 ENT - Airway obstruction

Noises

    • Stridor

      • Inspiratory

        • Obstruction is above the vocal cords

      • Biphasic

        • Obstruction is at the level of the vocal cords

      • Expiratory

        • Obstruction is just below the vocal cords

    • Sturtor

      • Obstruction in oropharynx

        • Tongue swelling

        • Ludwig's angina

        • Anaphylaxis

        • Angioedema

    • Wheeze

      • Lower airway obstruction

Causes of stridor in a child

    • Croup

      • 2-4 years

      • Parainfluenza virus

    • Laryngomalacia

      • Most common cause in infancy

      • Esp. <2 yrs

      • Soft, immature cartilage of the upper larynx collapses inward during inhalation

      • Exacerbated by reflux

    • Laryngospasm

    • Long intubation

      • => Granuloma formation => Subglottic stenosis

    • Vocal nerve palsy

Laryngeal nerve

    • Left branch loops under the aorta

      • Lower + longer => More risk of damage

    • Right branch loops under the right subclavian artery

Tracheostomy

    • Between second and third tracheal rings

    • Be careful not to do it through a tumour => Spread/Poor prognosis