Paeds: Acute Upper Airway Obstruction

Playlist contributed by Annabelle Skelley
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1.     Laryngotracheobronchitis (croup)

·      Age: 6m-3yrs

·      Narrowing of glottis & subglottic airway

·      Ballooning of hypophayrnx on lateral

·      “Steepling” of upper airway on frontal

2.     Acute epiglottitis

·      Age: 3-6yrs

  • Swollen/shortened epiglottis

·      Distension of hypopharynx/pyriform sinuses with air

  • Previously due to Hib -> but now group A strep due to vaccination

3.     Retropharyngeal abscess

·      Age: <2 yrs

·      Prevertebral soft tissue swelling

·      Gas/air fluid level

4.     Angioedema

·      Predominantly laryngeal oedema

·      History -> allergic, anaphylactic

5.     Foreign body

·      Usually bronchial obstruction rather than upper airway

·      Lateral decubitus to look for gas trapping

6.     Choanal atresia

·      Most common congenital nasal abnormality

·      Can be uni/bilateral

7.     Pyriform aperture stenosis

·      Bony overgrowth of the medial nasal process of the maxilla

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