Gyratory congenital stridor: causes, symptoms, diagnosis, treatment

A guttural congenital stridor is a syndrome that appears immediately after birth or during the first weeks of a newborn's life. This syndrome is characterized by a pronounced impairment of the respiratory function of the larynx, accompanied by a stridiform sound.

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What causes a laryngeal congenital stridor?

The causes of a laryngeal congenital stridor can be:

1. compression of the trachea with hypertrophied thymus or thyroid gland or compression of the bronchus with the trunk of the aorta or pulmonary arteries;
2. developmental defects of the epiglottis, tissues of the throat, thyroid cartilage or tracheal rings, cysts and diaphragms of the larynx, macroglossia, micrognathia with a dislocation of the tongue towards the entrance to the larynx;
3. congenital papillomatosis of the larynx;
4.  paralysis of recurrent nerves and ankylosis of the perichnecherylar joints, resulting from intrapartum trauma.

The laryngeal congenital stridor manifests itself in the so-called laryngomalacia, in which the cartilages of the larynx are very soft and elastic formations, which causes their retraction into the larynx lumen during inspiration under the influence of "negative" pressure. Especially intensively falls into the laryngeal lumen of the epiglottis, which causes its obstruction and stridorous sound on inspiration. These organic and functional disorders in laryngomalacia are observed in children with rickets, whose mothers did not observe a diet during pregnancy that promotes normal fetal development (deficiency of vitamins, calcium, phosphorus and other microelements, carbohydrates), or suffered any disease, influencing the development of a future child. The laryngeal congenital stridor can be caused by spasmophilia, which is also one of the manifestations of rickets, i.e., a violation of calcium metabolism.

Symptoms of a laryngeal congenital stridor

The main symptom of the laryngeal congenital stridor is a characteristic loud sound that occurs on the inspiration in the falsetto tonality when air is broken through the spasmodic larynx. On exhalation, this sound acquires the character of high-frequency white noise, similar to the one used in disguise of hearing. Stridor is detected immediately after birth or several weeks later. During sleep, his severity decreases, during crying and screaming of the child - is amplified. Breathing is more difficult than exhalation. In such children sonority of voice outside the attack of the stridor is not broken. During the stridor, there is a violation of breathing with the appearance of signs of asphyxia: cyanosis, disorientation in the surrounding environment, unrecognized close people, down to loss of consciousness, in which, however, the spasm of the larynx passes, and the child's condition returns to normal. Attacks of the laryngeal congenital stridor occur periodically at different frequencies within 2-3 months after birth, and if their cause is a functional disorder, their severity gradually decreases and by the end of the second year of life they completely disappear.

How is the laryngeal congenital stridor recognized?

Diagnosis is not difficult, but the diagnosis can be definitively established only after direct laryngoscopy and tracheobronchoscopy, and in some cases even after a thorough radiological examination of the child. Differential diagnosis is carried out with true and false croup, vulgar laryngitis, laryngeal papillomatosis, zagrugal abscess and other volumetric processes in the larynx and neck region.

Treatment of a laryngeal congenital stridor

Treatment of a laryngeal congenital stridor consists in providing the child with a normal mental situation, adequate nutrition, carrying out measures to normalize vitamin and mineral metabolism. Serious attention is paid to the prevention of ARI.

The laryngeal congenital stridor has a favorable prognosis, except for cases of acute stenosis or pronounced structural defects of the larynx, under which the prognosis becomes serious.