Critical Stenosis Because of Vocal Cord Synechiae in a Child.

Autor: Suárez-Bustamante Huélamo M; Pediatrician, Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. Electronic address: msuarezb@salud.madrid.org., Alonso-Cadenas JA; Pediatrician, Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatrician, Instituto de Investigación Sanitaria Hospital La Princesa (IiSHLPR), Hospital Universitario La Princesa, Madrid, Spain., Guillén Lozada E; Otorhinolaryngologist, Othorhinolaryngolgy Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Retuerta Oliva A; Pediatrician, General Pediatrics Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Gaitero Tristán J; Pediatrician, Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatrician, Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatrician, Instituto de Investigación Sanitaria Hospital La Princesa (IiSHLPR), Hospital Universitario La Princesa, Madrid, Spain., Leoz Gordillo I; Pediatrician, Pediatric Intensive Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., de la Torre Espí M; Pediatrician, Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Pediatrician, Instituto de Investigación Sanitaria Hospital La Princesa (IiSHLPR), Hospital Universitario La Princesa, Madrid, Spain.
Jazyk: angličtina
Zdroj: Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners [J Pediatr Health Care] 2024 Jan-Feb; Vol. 38 (1), pp. 86-89. Date of Electronic Publication: 2023 Aug 19.
DOI: 10.1016/j.pedhc.2023.07.003
Abstrakt: Stridor is a clinical sign of an underlying disease and a common reason for pediatric emergency department (PED) consultation. Patients presenting with stridor must be evaluated to determine the origin of this abnormality. We present the case of a 7-year-old female patient who presented to our Pediatric Emergency Department with a history of recurrent episodes of stridor with increasing frequency over the previous 4 years, for this reason she was previously admitted to the pediatric intensive care unit. Findings from the otorhinolaryngologic assessment with flexible fiber-optic endoscopy led to a diagnosis of congenital synechia of the vocal cords. The cervical CT scan evidenced critical stenosis of the airway. An initial cordectomy and placement of a silicone device for fixation were performed. Subsequently, the patient required 6 additional interventions for progressive dilation of the glottic space at the level of the vocal cords and injections of mitomycin C injections (an antineoplastic that inhibits collagen proliferation). This case highlights the importance of additional studies (especially examination of the upper airway) when atypical or recurrent findings are revealed by the clinical history, physical examination, or disease course in patients with croup to prioritize cases severe enough to require pediatric intensive care unit admission.
(Copyright © 2023 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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