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    This document presents a case study of a 2-year-old boy who presented with progressive respiratory distress over 1 month. Physical examination revealed biphasic stridor, supraclavicular retractions, and oxygen saturation of 94%. Flexible bronchoscopy showed large laryngeal papillomas causing near complete airway obstruction. Histopathology confirmed laryngeal papillomatosis. Any child with changing voice, stridor, or respiratory distress should undergo bronchoscopy to evaluate for laryngeal papillomatosis, which can cause progressive airway obstruction.

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    This document presents a case study of a 2-year-old boy who presented with progressive respiratory distress over 1 month. Physical examination revealed biphasic stridor, supraclavicular retractions, and oxygen saturation of 94%. Flexible bronchoscopy showed large laryngeal papillomas causing near complete airway obstruction. Histopathology confirmed laryngeal papillomatosis. Any child with changing voice, stridor, or respiratory distress should undergo bronchoscopy to evaluate for laryngeal papillomatosis, which can cause progressive airway obstruction.

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    This document presents a case study of a 2-year-old boy who presented with progressive respiratory distress over 1 month. Physical examination revealed biphasic stridor, supraclavicular retractions, and oxygen saturation of 94%. Flexible bronchoscopy showed large laryngeal papillomas causing near complete airway obstruction. Histopathology confirmed laryngeal papillomatosis. Any child with changing voice, stridor, or respiratory distress should undergo bronchoscopy to evaluate for laryngeal papillomatosis, which can cause progressive airway obstruction.

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    © All Rights Reserved
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    53 views1 page

    Poster

    Uploaded by

    Ahmad Ismatullah
    This document presents a case study of a 2-year-old boy who presented with progressive respiratory distress over 1 month. Physical examination revealed biphasic stridor, supraclavicular retractions, and oxygen saturation of 94%. Flexible bronchoscopy showed large laryngeal papillomas causing near complete airway obstruction. Histopathology confirmed laryngeal papillomatosis. Any child with changing voice, stridor, or respiratory distress should undergo bronchoscopy to evaluate for laryngeal papillomatosis, which can cause progressive airway obstruction.

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    BIPHASIC STRIDOR AS A RESPIRATORY

    SYMPTOM OF LARYNGEAL PAPILLOMATOSIS


    Dimas Dwi Saputro, Rifan Fauzie, Retno Widyaningsih
    Pediatric Respirology Division - Harapan Kita Women and Children

    Background
    Laryngeal papillomatosis has a hallmark of
    Objective
    progressive hoarseness, stridor, and respiratory
    To present biphasic stridor with the possible
    distress. Due to the fact that the most common
    development of respiratory distress as a respiratory
    symptoms are related to airway obstruction, many
    symptom of laryngeal papillomatosis
    children are misdiagnosed with croup, asthma, or
    chronic bronchitis. The incidence of laryngeal
    papilomatosis in children is 3.62 cases per 100.000.

    Case
    A two year-old boy came with a history of progressive
    difficulty in the breathing since 1 month before admission.
    He has evaluated in another hospital and refered to our
    hospital where flexible bronchoscopy was performed due to
    his respiratory distress
    a b
    Physical examinations revealed poorly nourished, anxious
    child with grade III laryngeal obstruction (Freitag
    classification). His respiratory rate was 40x/minutes. Severe
    supra sternal retraction with biphasic stridor was noted. On
    auscultation, bilateral air entry was reduced with his room air
    saturation around 94%, his heart rate was 140/minutes.
    No history of illness before

    Flexible bronchoscopy examination revealed large polyp c d


    arrising from glottis causing airway obstruction, and multiple
    papilloma on both valve vocal cords. Histopathology
    showed a paracheratotic squamous lesion with little
    hyperplasia and polyploid form of the cell. Besides that, the
    vessels were hyperemic in subepitelial space. This finding
    consistent with laryngeal squamous papillomatosis

    The lesions were removed by microlaryngeal excision in the


    previous hospital. The boy was stable through out
    procedures and was evaluated the reccurent of papilloma
    e
    monthly in outpatient clinic Figure 1. The flexible bronchoscopy
    examination showed multiple laryngeal
    papillomas and near complete obstruction
    in supraglotic area (a,b,c,d)
    Conclusion
    Any child with voice changing, obstructive airway symptoms should get fiberoptic bronchoscopy to rule out
    neoplasia with laryngeal papillomatosis being high on the differential. A careful history should be obtained in
    persistent or progressive stridor and dysphonia with the possible development of respiratory distress

    17th Indonesian Congress of Pediatrics (KONIKA XVII) Jogja, August 8-11, 2017

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