Mohammad Riaz Akhtar, Shakeel Ahmed, Syed Nusrat Raza.
Stridor in afebrile children.
Pak Armed Forces Med J Jan ;56(1):16-22.

Objective: To enlist the causes of stridor in afebrile children under twelve years of age. Design: Descriptive study. Place and Duration of Study: Carried out in ENT Dept CMH Rwp from Sep 2001 to Feb 2003. Patients and Methods: Fifty children presenting for the first time with symptoms of stridor were selected according to the inclusion criteria by non-probability purposive sampling. Every patient was evaluated by detailed history, thorough physical examination and investigations including radiographic studies, laryngoscopy and bronchoscopy. Data was recorded on the performa attached as Annex `A`. Results: Of the 50 patients, there were 29 males and 21 females. The mean age at presentation was 3.8 years. About forty-eight diagnostic observations were made during the initial endoscopic procedure on these 50 children. Acquired lesions (76%) outnumbered the congenital lesions (24%). Of the congenital type, laryngomalacia (42%) was the commonest cause followed by vocal cord paralysis (17%), laryngocele (17%), laryngeal web (8%), tracheomalacia (8%) and tracheal stenosis (8%). The most important acquired lesion was foreign body in the Aerodigestive tract (55.26%), followed by respiratory papilomatosis (21.05%), traumatic (13.16%) and subglottic stenosis (10.13%) Because of chronic and presistent upper airway obstruction, tracheostomy was electively performed in 02 cases in this series. There was no complication associated with complete endoscopic examination Conclusion: Foreign body in the tracheobronchial tree is the most frequent cause of stridor in afebrile children followed by congenital conditions and recurrent respiratory papillomatosis.

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