The mouth is held open with the jaw forward and cough is absent. Similarly patients with supraglottic laryngeal obstruction have almost an identical clinical presentation. T his is decidedly different from children with glottic obstruction who usually present with marked hoarseness and may be aphonic. Their stridor is usually inspiratory but may become expiratory with increased observation. Retractions are usually intercostal and xiphold.
Patients generally are able to eat well and their mouth is usually closed during respiration.
Nasal flaring is common with increased obstruction and no cough is present. Patients with sublglottic obstruction present in a very similar manner to those with glottic obstruction. However, their voice may be normal and these children often times have a barking cough. On the other hand patients with tracheobronchial obstruction usually have a normal voice. Specifically evaluation of the patient under general anesthesia may precipitate an acute respiratory event secondary to airway collapse.