"Parents are the best
doctors for their children"
-Dr. Kanotra
Laryngomalacia
This condition involves the floppiness of the larynx (voice box) tissues above the vocal cords, causing a partial airway obstruction. Symptoms can range from noisy breathing (stridor) to feeding difficulties, poor weight gain, choking, apnea (pauses in breathing), and cyanosis (blue spells). Diagnosis often involves a physical exam and nasopharyngolaryngoscopy. Treatment options include medical management for mild cases and supraglottoplasty surgery for more severe cases.
Tracheomalacia
This disorder is characterized by weakness or floppiness of the trachea (windpipe) walls, leading to collapse during breathing. Symptoms can include noisy breathing, breathing difficulties that worsen with coughing or crying, a high-pitched cough, and recurrent respiratory infections. Diagnosis may involve X-rays, airway fluoroscopy, laryngoscopy, and bronchoscopy. Treatment ranges from humidified air and medications to surgery in severe cases, such as aortopexy or tracheopexy.
Subglottic Stenosis
This involves a narrowing of the airway below the vocal cords. Symptoms can include stridor, respiratory distress, recurrent croup, and a hoarse or weak voice. Diagnosis is typically confirmed through microlaryngoscopy and bronchoscopy. Treatment options vary based on severity, from observation and endoscopic dilation to open surgical reconstruction like laryngotracheal reconstruction (LTR) or cricotracheal resection (CTR).
Vocal Cord Paralysis
This occurs when one or both vocal cords do not move properly. Symptoms can include noisy breathing, difficulty breathing, frequent pneumonias due to aspiration, and a breathy or hoarse voice. Diagnosis involves a physical exam and laryngoscopy. Treatment may include observation, voice therapy, or surgery.
Stridor
This is a high-pitched, noisy breathing sound resulting from an obstruction in the throat or upper airway. It is a symptom of various underlying conditions like laryngomalacia, subglottic stenosis, or the presence of foreign bodies. Diagnosis involves identifying the cause through physical examination and potentially endoscopic procedures. Treatment focuses on addressing the underlying cause of the obstruction.
Croup
This is a viral infection causing swelling in the airway, leading to difficulty breathing. It typically presents with a barking cough, wheezing, and stridor. Diagnosis is often clinical, based on symptoms. Treatment usually involves supportive care, such as humidified air and sometimes medications like corticosteroids.
Chronic Cough
A persistent cough can be a symptom of various underlying issues, including asthma, allergies, gastroesophageal reflux disease (GERD), or postnasal drip. Diagnosis involves a thorough medical history and physical exam, potentially with further testing to identify the cause. Treatment focuses on managing the underlying condition.
Dysphagia
This term refers to difficulty swallowing, encompassing problems with moving food or liquid from the mouth to the stomach. Causes can include neurological disorders, structural abnormalities like cleft palate, developmental delays, and gastroesophageal reflux disease (GERD). Symptoms may involve coughing, choking, food refusal, slow feeding, food sticking in the throat, and weight loss. Evaluation often involves clinical assessments and instrumental studies like VFSS and FEES. Management strategies include diet modifications, feeding therapy, and sometimes medical or surgical interventions.
Aspiration
This occurs when food or liquid enters the airway or lungs. It is often a consequence of dysphagia and can lead to serious complications like pneumonia. Symptoms can include coughing or choking during or after eating, a wet voice after eating, frequent respiratory infections, and difficulty breathing while eating. Evaluation involves assessing swallowing function through clinical exams and instrumental studies. Management focuses on strategies to ensure safe feeding, such as modifying food textures and consistencies, adjusting feeding techniques, and potentially using feeding tubes.
Feeding Difficulties in Infants
Infants can experience various feeding difficulties related to coordination of sucking, swallowing, and breathing, latching issues during breastfeeding, and transitioning to solid foods. Causes can range from prematurity and developmental delays to anatomical abnormalities and sensory issues. Symptoms may include poor weight gain, refusing food or liquids, gagging, coughing, and prolonged feeding times. Evaluation involves observing feeding behaviors, assessing oral motor skills, and potentially conducting swallow studies. Management strategies often include feeding therapy, modifications to feeding techniques and equipment, and nutritional support.