Stridor in Paediatrics (Dr Lynn Koh & Dr Tay SY) Top 3 causes of stridor in neonates Laryngomalacia SGS BVCP Choanal atresia SGH Commones t 1 2 3 - - Aggravat ed Activity, crying, feeding, URTI History to ask SPECS R Voice, hoarseness, volume of cry FB history, cardiac history, previous intubation, cyanosis, apnea, sleep, thrive, feeding (choke/regurg) Onset Few weeks after At birth (Mild ones can present as recurrent URTI/Croup after birth) At birth At birth Few weeks after Associat ion 50% of SGH will have cutaneous hemangiomas, reverse is not true Features on scope Accentuated omega shaped epiglottis Short AE folds Retroflexed epiglottis Inthrowing of epiglottis and AE folds during inspiration Redundant supraglottic mucosa and prominent cuneiforms Rigid scope vs Flexi scope - Magnified view of larynx, superior image quality - Lower airway can be examined - Both diagnostic and therapeutic - Controlled environment, ventilation can be secured - Can palpate CA joint and any laryngeal cleft - Child under GA, not office procedure, VC not mobile, laryngeal dynamics cannot be assessed