Stridor associated with essential laryngeal myoclonus
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Airway obstruction
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Abstract Obstruction of the laryngeal airway is a life threatening problem due normally to obstructive pathology within the upper aero-digestive tract. We describe four cases of laryngeal stridor (two adults and two children) of psychogenic origin, one of which required a tracheostomy. The literature is reviewed and the subsequent pattern of this disease documented on the basis of 28 patients previously described.
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Granular cell tumors (GCTs) are neoplastic lesions rarely seen in adults. GCTs are most commonly found in the head and neck region, and exceptionally on the larynx. Laryngeal GCTs symptoms and signs may manifest as hoarseness, dysphagia, coughing, hemoptysis, and stridor. We report a case of a 36-year-old woman, who complained of dysphonia. Her clinical history, pathological findings, and treatment are addressed in this article.
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The literature contains records of 18 infants with stridor due to haemangiomata in or just below the larynx.Two of these were reported by Mr. James Crooks in this Journal (Crooks, 1954).Since then he has had three further cases at The Hospital for Sick Children, Great Ormond Street, and I am indebted to him for permission to publish details of two of them, bringing the total number of cases recorded up to 21.Case Histories Case 1. (Fig. 1).C.E. was a girl born on January 6, 1956.Laryngeal stridor developed after an attack of acute FIG.1.-Case 1. Child after removal of tracheostomy tube.
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A variety of lesions can be seen in the larynx subsequent to an intubation anaesthesia or treatment with a respirator. The larynx may already be injured by introducing an endotracheal tube. The inserted tube must necessarily chafe the laryngeal mucosa. Many studies are concerned with individual manifestations [5-10,14,16,17,20]. The following article gives an overview of the intubation lesions of the larynx observed by us and offers comments on pathogenesis and prevention.161 patients with severe lesions subsequent to an intubation or treatment with a respirator were seen at the ENT Department of the University of Marburg Hospital from 1973 to 1995. TYPES OF LESIONS CAUSED BY INTUBATION: Basing on the pathomechanisms, we can classify the lesions as follows: inflammatory reactions, lesions of the larynx caused during intubation, lesions caused by chafing by the tube or by the sealing sleeve.Considering the large number of performed intubations, lesions of the larynx occur rarely. However, in view of the possible sequels, it would be advisable if an experienced laryngologist would perform a careful endoscopic examination of the larynx and trachea at least after every forced or prolonged intubation and especially after every treatment with a respirator.
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Laryngeal stenosis may be considered as acute or chronic, depending on the cause and the duration of symptoms. Any condition that narrows the lumen of the larynx and subglottic area in a relatively short time will cause laryngeal symptoms of acute stenosis, while symptoms in chronic stenosis may be insidious, developing over a longer period. Laryngeal symptoms, whether acute or chronic, when encountered in children differ in many respects from laryngeal symptoms in adults, for several reasons; in fact, the symptoms may differ in the same disease in children and adults. The cartilages and general structure of a child's larynx are extremely delicate, and the glottic chink in a normally developed larynx is small and readily encroached on by a slight amount of inflammation or swelling of the laryngeal mucosa, a condition which interferes with respiration. The subglottic area in children under 3 years of age is vascular and the
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