- Clinical grades of stridor.

Clinical grades of stridor.

1.Grade 1 (Exertional stridor) :
Stridor appears during crying or exercise.
2.Grade 2 (Continuous stridor or stridor at rest) : 
Stridor is present at rest & become worse with exertion.
 3.Grade 3 (Stridor with retractions) : 
Stridor is continuous & accompanied with suprasternal& supraclavicular retractions. The patient looks anxious, irritable, struggling for breathing.
4.Grade 4 (Stridor with cyanosis) :
 In addition to continuous stridor & retractions, cyanosis& altered consciousness occur denoting severe respiratory failure. ET intubation may be considered.

- Causes of stridor In pediatrics.

Causes of stridor according to site of obstruction.

-Nose and pharynx: (by laryngeal compression)

• Lingual thyroid or thyroglossal cyst 
• Macroglossia(Beckwith-Wiedemann syndrome, hypothyroidism, Pompe disease, trisomy 21, hemangioma).
• Micrognathia (Pierre Robin syndrome, Treacher Collins syndrome,DiGeorge syndrome)
• Hypertrophic tonsils/adenoids
• Retropharyngeal or peritonsillar abscess / hematoma
• Tongue teratoma or dermoid 
• Masses: e.g. cystic hygroma or other malformation

-Larynx:
Not acute:

• Laryngomalacia
• Congenital subglottic stenosis
• Vocal cord paralysis
• Laryngeal atresia/web 
• Congenital Subglottic hemangioma
• Vascular ring compression syndrome.
• Laryngocele/cyst
• Laryngeal papillomas 
• GERD

- Shorter Antibiotic Treatment for Otitis Media!

Shorter Antibiotic Treatment for Otitis Media!