Stridor and Congenital Conditions of Larynx MCQs

This is an acute airway emergency. The tube should be removed immediately and replaced with a new tube. Oxygen will not help the patient as the tube is already blocked. Deriphyllin is a bronchodilator. It has no role in management of a blocked tube. Suction of the tube after putting normal saline helps in clearing the crusts. This helps to prevent blockage of the tube but is not helpful after blockage has occurred. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page Number-372.

Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is a condition related to HPV 6 and 11 infection which is characterized by the repeated growth of benign exophytic papilloma in the respiratory tract of children. Cidofovir is used locally in JORP. Reference: Diseases of Ear, Nose, AND Throat by PL Dhingra

In children, vegetable foreign bodies are common with peanuts being the most common. A normal chest X ray is seen in early cases within 24 hours or when a foreign body causing partial obstruction with full ingress and egress of air does not produce any sign. Most foreign bodies enter the right bronchus because it is wider and more in line with the tracheal lumen. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Page Number-377, 375.

Ans. is d i.e., Diffuse Esophageal spasm Radiological appearances of diffuse esophageal spasm have been described as: curling esophagus Corkscrew esophagus or - pseudodiverticulosis Diffuse esophageal spasm is a motor disorder of esophagus characterized by repetitive simultaneous non-peristaltic contractions. Symptoms are substernal chest pain and/or dysphagia Diagnosed by manometry Also know Nutcracker esophagus also known as 'supersqueezer' esophagus - it is characterized by extremely high-amplitude peristaltic contraction - Symptoms are pain and dysphagia Diagnosed by manometry study which shows peristaltic esophageal contractions with peak amplitudes greater than two standard deviations above the normal values.

Lupus larynx affects anterior larynx. It most commonly involves epiglottis. Intubation granuloma involves the posterior thirds of the vocal cords. Pachydermia laryngis is heaping up of epithelium in interarytenoid region and posterior part of vocal cords. Tuberculosis larynx most commonly forms lesions in posterior part of larynx. REF:- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no – 343, 342, 354

This is a case of acute laryngotracheobronchitis (croup). Treatment includes: Hospitalization & IV fluids I/v steroids : to reduce edema especially when child is in distress Humidified air to soften crusts Racemic Adrenaline via a respirator - Bronchodilator Intubation / tracheostomy may be needed Antibiotics are only given to prevent secondary infection. Croup is usually caused by viral infections, and antibiotics are not the mainstay of treatment. Supportive care, such as humidified air, hydration, and sometimes corticosteroids, is more commonly used. Antibiotics are not effective against viral infections. Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, pg. no – 339, 340

Laryngomalacia manifests at birth or soon after, and usually disappears by 2 years of age . So reassurance is the ideal strategy. Tracheostomy may be required for some cases of severe respiratory obstruction. Supraglottoplasty is required in cases of severe laryngomalacia. Steroids have no role in the management of laryngomalacia. REF:- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no 344

Acute epiglottitis Primarily affects children of 2–7 years of age but can also affect adults. The most common organism responsible for this condition in children. Streptococcus Pneumoniae & Haemophilus Infuenzae B is second common aetiological agent. Parainfluenza virus causes croup (Acute laryngotracheobronchitis). Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no – 338