Pediatric Airway: Cry, Stridor and Cough

Pediatric Airway: Cry, Stridor and Cough

by Jeno Hirschberg

The result of 45 years' study of pediatric laryngology, phoniatrics, and bronchology, this book describes 42 different pathological sounds - occurring in different combinations - in 54 different pathological conditions. Uniquely, while recognizing the indispensability of conventional investigation methods - endoscopy, radiology, MRI - the Editors demonstrate the

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The result of 45 years' study of pediatric laryngology, phoniatrics, and bronchology, this book describes 42 different pathological sounds - occurring in different combinations - in 54 different pathological conditions. Uniquely, while recognizing the indispensability of conventional investigation methods - endoscopy, radiology, MRI - the Editors demonstrate the value of perceptive-auditive evaluation and objective acoustic analysis as a complimentary diagnostic tool. With an accompanying DVD, they visually - through spectograms, endoscopic photos, and radiologic or MRI pictures - and audibly demonstrate the acoustic characteristics of the pathological sound phenomena, the different irregular or unusual sounds occurring in, and the characteristic of each respiratory or neuro-developmental disease and disorder. Their coverage of the latest therapeutic options for each disease or disorder renders this book a virtual guide to every aspect of pediatric laryngology. Throughout, the editors demonstrate the value of this complimentary diagnostic and rehabilitation tool for airway obstructions and the various pathological and neuro-developmental anomalies in the pediatric population. The multidisciplinary approach has been deliberate in making the book accessible to pediatricians and speech pathologists, as well as its core audience: otolaryngology-head and neck surgeons.

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Product Details

Plural Publishing
Publication date:
Edition description:
Book and DVD
Product dimensions:
7.20(w) x 10.20(h) x 0.90(d)

Table of Contents

Contributors     xi
Preface     xiii
Introduction   J. Hirschberg   T. Szende   P. Koltai   A. Illenyi     1
The Sound Phenomena Investigated: Cry, Stridor, and Cough   J. Hirschberg   T. Szende   P. Koltai     3
Cry     3
Stridor     4
Cough     5
Historical Background   J. Hirschberg     7
The infant cry     7
Stridor     24
Cough     28
Patients   J. Hirschberg   P. Koltai   Zs. Farkas     31
Methods     35
Conventional examination methods, their critical analysis and sphere of indication   I. Lellei   J. Hirschberg   P. Koltai   Zs. Garay     35
Examination in cases with pathologic phonation, unusual infant cry     35
Evaluation of stridor     39
Evaluation of cough     43
Basic principles of acoustics, methods of acoustic investigation, sound spectrography   T. Szende   A. Illenyi     44
The acoustic structure of sound phenomena     45
Voiced sounds (frequency characteristics)     45
Noise     46
Aphonia     46
Duration (length) of sounds     46
Intensity     47
Melody of the cry     47
Resonance components     47
Applied methods for acoustic analysis     48
Sound spectrography     48
Minimal time interval spectrum     51
Measurement of the fundamental frequency     52
Analysis of the infant cry with digital signal processing (DSP)   Gy. Varallyay     53
Why analyze?     53
The infant cry as an acoustic signal     54
Data collection     55
Available techniques to record the infant cry     55
Database     57
Preprocessing of the infant cry     58
Filtering     58
Segmentation     59
Processing of the infant cry     60
Attributes in the time domain     60
Discrete Fourier Transform     61
Acoustic attributes in the spectrum     62
Methods for detecting fundamental frequency     64
Detecting the melody contour of the infant cry     66
Digital spectrograph     67
Results     70
Duration of cry segments      70
Fundamental frequency     70
Development of the fundamental frequency     71
Melody of the infant cry     72
Evaluation     72
Sound in medicine; noninvasive diagnostic methods     73
Nasometry   Zs. Trenovszki   J. Hirschberg     75
Bioinformatics and genomics   Z. Benyo   B. Benyo     76
Characterization and Acoustic Description of the Most Commonly Occurring Sound Signals   T. Szende   J. Hirschberg     81
Cries     81
Clear (pure, regular, normal) cry     81
Veiled cry     84
Hoarse cry     84
Hyperfunctional (tense) cry     84
Pressed (forced) cry     84
Raucous (harsh) cry     87
Crackling cry     87
Sharp cry     87
Shrill (piping, shrieking, screeching) cry     88
Creaking cry     89
Very high (high-pitched) cry     89
Bleating (quavering) cry     90
Sizzling (fizzling, crepitating) cry     90
Faint (inert, weak, languid) cry     91
Wan (meager, low-energy) cry     91
Bitonal cry     94
Broken phonation (breaking, breaklike) cry     94
Aphonic cry     94
Hollow (cavernous) cry     97
Dull (colorless) cry     97
Types of stridor     99
Pharyngeal-type stridor     99
Interrupted pharyngeal stridors (with quasiperiodic acoustic structure)     102
Sawing (buzzing) stridor     102
Rasping stridor     102
Croaky stridor     102
Snoring (snorting, stertorous, grunting) stridor     102
Bubbling (gurgling) stridor     105
Divided pharyngeal stridor     105
Lump-in-the-throat stridor     105
Supraglottic stridor (high, sharp, and loud inspiration and expiration)     106
Cackling (clucking) stridor     106
Hissing (whistling, sibilant) stridor     108
Stridor-phonation     108
Crowing stridor     111
Stridor of subglottic character     111
Deep-hollow stridor     111
Hollow stridor     112
Tracheal stridor     112
Spastic (wheezy) expiratory stridor     115
Coughing sounds     115
Nondescript cough     115
Catarrhal cough     116
Barking cough      116
Cough-phonation     116
Deep cough     119
Hollow cough     119
Ringing cough     119
Brassy, ringing cough     119
Metallic, ringing cough     122
Staccato cough     122
Suppressed, painful cough     122
Airway and Nervous Anomalies Associated with Pathologic Sound Production     125
Disorders affecting the nose, oral cavity, pharynx, and ears   J. Hirschberg   Zs. Farkas   P. Koltai     125
Choanal atresia     125
Micrognathia     129
Robin sequence     131
Cleft palate (CP), velopharyngeal insufficiency (VPI)     133
Hearing impairment, hearing loss     137
Cornelia de Lange syndrome     141
Hurler's syndrome (multiple dysostosis, gargoylism)     141
Mental retardation, mental deficiency     143
Enlarged, hypertrophied tonsils, adenoid vegetation     144
Disorders affecting the larynx   J. Hirschberg   P. Koltai   I. Lellei   Zs. Garay   G. Katona     146
Epiglottitis (supraglottic inflammation)     146
Acute laryngitis     149
Laryngeal croup (acute fibrinous laryngitis)     151
Laryngeal thrush, laryngeal mycosis, fungal laryngitis     153
Changes following prolonged intubation, acquired laryngeal stenosis     154
Papilloma of the larynx (upper respiratory papillomatosis)     161
Vocal cord polyp, laryngeal fibroma     165
Laryngeal cysts     166
Laryngocele     168
Laryngeal cleft     170
Laryngomalacia (chondromalacia laryngis, soft, flaccid larynx)     171
Atresia, severe stenosis of the glottis     175
Laryngeal diaphragm (congenital laryngeal web)     176
Vocal cord paralysis (abductor [recurrent] and adductor paresis)     181
Dysphonia     187
Hyperbilirubinemia     189
Down syndrome     194
Cri du chat syndrome (cat's cry disease)     196
Myasthenia gravis     198
Amyotonia congenita (congenital muscular atony, Oppenheim's disease)     201
Polyradiculitis (Guillain-Barre syndrome)     202
Pseudocroup (subglottic laryngitis)     204
Subglottic stenosis     205
Subglottic hemangioma     214
Contusion (injury) of the larynx     217
Tracheal changes   J. Hirschberg   P. Koltai   I. Lellei   K. Hirschberg     218
Congenital goiter     218
Vascular anomalies     220
Paratracheal or parabronchial lymphadenitis (thoracic lymph node enlargement, lymphadenopathy, bronchial rupture)     225
Mediastinal tumors     226
Tracheomalacia (functional stenosis of the trachea, soft trachea)     228
Circumscribed congenital anomaly of the tracheal cartilages (individual cartilage deformity)     232
Tracheal dyskinesia     233
Rigid trachea stenosis (congenital fibrous stricture)     235
Stenosing laryngotracheobronchitis (sicca maligna)     237
Foreign bodies in airways     239
Disorders affecting the bronchi and the lungs   J. Hirschberg   G. Katona     240
Wheezy bronchitis, asthma     240
Pertussis (whooping cough)     242
Pneumonia     244
The Diagnostic Value of the Conventional Examination Methods and of Acoustic Analysis   J. Hirschberg   T. Szende   I. Lellei     247
Cries     247
Classification in terms of the acoustic substrate     248
Noise     249
Other structural changes     250
Classification in terms of the location of changes     254
Classification on grounds of etiology     256
The diagnostic values of clinical (imaging) methods in the evaluation of infant cry     256
Stridor     258
Pharyngeal stridors     259
Laryngeal stridors     260
Subglottic and tracheal stridors     261
Bronchial stridors     262
Cough     262
Summary   J. Hirschberg   T. Szende   P. Koltai   A. Illenyi     265
References     269
Subject Index     299

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