• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.775-779
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• 2008

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.1
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• pp.20-24
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• 2017

Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.122-126
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• 1998

Laryngomalacia is the most common cause of inspiratory stridor and varying degrees of airway obstruction in infants but rarely occurs in children or adults. However, acquired airway obstruction would be developed due to the presence of redundant mucosa in the aryepjglottic folds similar to that seen in congenital laryngomalacia after central nervous system damage. To this condition, the term“Neurasthenic Laryngomalacia”is applied. We have recently experienced a case of neurasthenic larygomalacia, which has been managed by laser aryepiglottoplasty with good result. We report management and outcome of this patient with a review of the literatures.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.32-35
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• 2013

Six English Bull dogs from the same dog training camp were referred with main complaints of stridor, gagging and coughing. Diagnostic imaging studies on these dogs revealed hypoplastic trachea with/without bronchopneumonia. The mean age of affected dogs was $4.83{\pm}2.63$ months, while the mean body weight was $9.03{\pm}5.30$ kg. The mean ratio of the tracheal diameter to the thoracic inlet distance (TD/TI) was $0.085{\pm}0.022$ (normally 0.16 or greater), whereas the mean ratio tracheal diameter to the width of the third rib (TD/W3R) was $1.36{\pm}0.36$ (normally 2 or greater). All dogs had marked inspiratory dyspnea with variable degree of coughing. Of 6 dogs, 4 dogs had either bronchitis or bronchopneumonia. Treatment with antibiotics and bronchodilators made improvement on clinical signs on these dogs. Although some dogs still had mild inspiratory dyspnea (especially after exercise or excitement), most dogs live normally.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.588-592
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• 1992

Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.235-238
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• 1997

Laryngeal saccular cyst may develop when obstruction of the orifice of the saccule occurs with resultant dilatation of saccule. It is classified into anterior saccular cyst and lateral saccular cyst. When saccular cyst occurs in infancy, it usually may cause respiratory distress, inspiratory stridor, cyanosis and dysphagia. In adults, it may cause hoarseness, dyspnea, dysphagia, pain and neck mass. The laryngeal saccular cyst may be treated by its removal with endoscopic or external approach, depending on the classification of saccular cysts, its size and individual patient factor. Recently, we have experienced a case of laryngeal saccular cyst so we report our clinical experience with brief review of literature.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.449-454
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• 1996

Functional upper airway obstruction due to vocal cord dysfunction is being increasingly recognized and has been variously described as "Munchausen's stridor", "Emotional laryngeal wheezing", "Nervous asthma". It's features are symptoms of acute reversible recurrent dyspnea associated with an inspiratory stridor, normal anatomy of the upper airway, demonstration of variable severe exthrathoracic upper airways obstruction with pathologic adduction of the vocal cord at bronchoscopy. The patients with this condition are frequently misdiagnosed as asthma and the diagnosis is often delayed. So they can present a serious medical problem and are exposed to the complication of treatment and investigation. We report a case of functional upper airway obstruction due to vocal cord dysfunction who showed paradoxical vocal cord motion at bronchoscopy and typical features of variable exthrathoracic obstruction on Flow-volume loop during a symptomatic period.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.146-151
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• 2001

Background and Objectives： Primary benign masses in subglottis and trachea are rare. Symptoms of tracheal obstruction are similar to those of bronchial asthma, chronic bronchitis, as well as malignant lesions. Materials and Methods： Eight patients with benign tracheal masses from April 1992 through June 2001, at otolaryngology-head and neck surgery. department of Seoul national university hospital were studied by retrospective medical record review. Results : They were 3 females and 5 males aged from 0 to 57 years. The pathologies of the intratracheal masses were lipoma. tuberculosis, pleomorphic adenoma, hemangioma(two case), reparative giant cell granuloma, epithelial inclusion cyst and nonspecific lymphadenopathy, respectively. The most characteristic symptoms were dyspnea and stridor, both inspiratory and expiratory. Five of them had been treated as bronchial asthma. Conclusion： For the management of patients with the subglottis and tracheal masses, it is important to establish secure airway. regardless of pathology of the masses. The diagnosis should be considered in any patient with asthma-like manifestation, especially who fails to respond to medical treatment. It is necessary to examine the airway thoroughly, and chest and simple cervical X-ray may contribute to the diagnosis of possible intratracheal mass.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.766-775
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• 1997

Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.