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Diagnóstico endoscópico de estridor na infância

Endoscopic diagnosis of stridor in childhood

Vítor Emanuel Cassol

ABSTRACT

Objective: To determine the main endoscopic diagnoses identified in children presenting stridor, at the Pediatric Unit of the General University Hospital of Santa Maria, Rio Grande do Sul, Southern Brazil. Methods: This is a cross sectional, uncontrolled, descriptive study. Data were obtained from the records of 56 consecutive patients submitted to bronchoscopy due to stridor; from March/93 to November/99. Results: Fifty-six bronchoscopies were performed and 59 lesions compatible with the diagnosis of stridor were observed. Patients were predominantly males (63%). Congenital anomalies and acquired lesions were observed in 45% and 50% of the cases, respectively. The remaining 5% of the cases were normal. Laryngomalacia, subglottic stenosis, tracheobronchomalacia and laryngeal edema were the most common diagnoses. Conclusions: The investigation of the respiratory tree by endoscopy is important for the correct diagnosis of children with stridor. Congenital or acquired diseases were similarly frequent as the cause of stridor. The endoscopic procedure was very valuable and yielded a high diagnostic rate.

Keywords: Thoracoscopy. Diagnosis. Respiratory sounds.

RESUMO

Objetivo: Determinar os principais diagnósticos endoscópicos identificados em crianças que apresentam estridor, no Serviço de Pediatria do Hospital Universitário de Santa Maria. Métodos: Estudo descritivo, do tipo transversal, não controlado, com dados obtidos de protocolos preenchidos quando realizada a endoscopia respiratória, no período de março/93 a novembro/99. Resultados: Foram realizadas 56 endoscopias respiratórias e identificadas 59 alterações compatíveis com o diagnóstico clínico de estridor, sendo 63% pacientes do sexo masculino. Lesões congênitas e adquiridas foram diagnosticadas em 45% e 50% dos casos, respectivamente, com 5% de endoscopias normais. Os diagnósticos mais comuns foram laringomalacia, estenose subglótica, traqueobroncomalacia e edema de laringe. Conclusões: A investigação da via respiratória pela endoscopia demonstrou ser importante para o correto diagnóstico do estridor. Doenças congênitas ou adquiridas tiveram freqüência similar como causa de estridor. A investigação endoscópica revelou-se de grande valor, com elevado percentual de diagnóstico.

Palavras-chave: Toracoscopia. Diagnóstico. Sons respiratórios.


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