Laryngeal dyskinesia as a cause of stridor in infants.
OBJECTIVE
To describe 9 cases of stridor attributed to the failure of the vocal cord to abduct during inspiration.


METHODS
Case series.


METHODS
Pediatric otolaryngology referral center.


METHODS
Nine hospitalized infants, aged 1 to 13 months, presented over a 3-year period for exploration of inspiratory stridor that was attributed to a condition that we have termed laryngeal dyskinesia.


RESULTS
A consistent clinical presentation was noted in all cases. The laryngeal dyskinesia occurred during calm breathing, crying, or sleep and was associated with gastroesophageal reflux in 8 cases (diagnosed clinically and/or with pH monitoring). In addition, 3 infants suffered from fainting spells associated with vagal hypertonia that was confirmed by 24-hour Holter monitoring. True paralysis of the abductor muscles was ruled out in all infants because of the presence of normal glottic motion during calm breathing or induction of anesthesia. The stridor resolved between the ages of 4 and 13 months in 7 of the patients. Improvement was progressive and had no clear relationship to treatment for gastroesophageal reflux.


CONCLUSIONS
Laryngeal dyskinesia in infants seems to be a distinct clinical entity, frequently associated with gastroesophageal reflux.
Denoyelle
F
F
Department of Pediatric Otolaryngology and Cervicofacial Surgery, Armand Trousseau's Children's Hospital, Paris, France.
Garabedian
E N
EN
Roger
G
G
Tashjian
G
G
D000367:Age Factors; D015716:Electrocardiography, Ambulatory; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications; D005931:Glottis / Q000502:physiology; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000150:complications* / Q000175:diagnosis; D009069:Movement Disorders / Q000150:complications* / Q000175:diagnosis; D012119:Respiration; D012135:Respiratory Sounds / Q000209:etiology*; D013575:Syncope / Q000150:complications; D013997:Time Factors; D014630:Vagus Nerve / Q000502:physiology