Treatment methods for laryngeal stridor, choose the method according to the condition

Laryngeal stridor is a very common phenomenon in babies shortly after birth. The symptoms will be obvious when they cry. In many cases, it is caused by calcium deficiency. If there are no other symptoms, no treatment is required. If the situation is serious, a tracheotomy can be performed.

1. Treatment of laryngeal stridor

If the symptoms are not serious, no treatment is required. Congenital laryngitis can usually heal itself by the age of 2 to 3 years. Therefore, the family members can be advised to put their concerns aside and pay attention to preventing cold and fright in order to avoid respiratory tract infections and laryngeal spasms, which will aggravate laryngeal obstruction. If the attack is severe and breathing is difficult, the baby's position can be adjusted. Placing the baby in a side-lying position can alleviate the symptoms. Occasionally, severe laryngeal obstruction may require tracheotomy.

Pathogenesis

Laryngitis is caused by turbulent airflow through narrowed segments of the airway during inspiration or expiration.

1. Physiological and anatomical characteristics: Newborns are more prone to airway stenosis due to their smaller airway diameter, and the cartilage supporting the airway is poorly developed, making it prone to twisting and collapse. Therefore, the airway of newborns is more prone to physiological stenosis than children of other age groups.

The airway can be divided into three parts anatomically:

① Supraglottic part: including nose, nasopharynx, oropharynx and hypopharynx.

② Laryngeal segment (glottic segment): includes vocal cords, subglottic area, and cervical trachea segment.

③Intrathoracic segment: includes the trachea and bronchi in the chest cavity.

2. Inspiratory stridor: The supraglottis is the weakest part of the newborn. Obstructive diseases in this area can often cause inspiratory stridor. For example, micrognathia or macroglossia can block the airway due to the tongue falling back.

3. Biphasic stridor: The larynx is the narrowest part of the neonatal airway anatomy. Diseases here such as congenital laryngomalacia, vocal cord paralysis, subglottic stenosis, laryngeal webs, subglottic hemangioma and laryngeal cyst can all cause laryngeal obstruction. Airflow is affected equally during inspiration and expiration, resulting in a typical biphasic stridor.

4. Expiratory laryngitis: Congenital abnormalities of the trachea and bronchi in the chest cavity are relatively rare. For example, tracheal softening, tracheal stenosis, congenital abnormalities of the great blood vessels compressing the airway, or airway inflammation caused by recurrent gastroesophageal reflux can all cause airway obstruction in this section, which manifests as expiratory laryngitis.