Stridor is noisy inspiration from turbulent gas flow in the upper airway. This chapter discusses the use of Heliox for temporarily treating stridor in the setting of ENT pathology. Stridor has many potential causes. It may occur as a result of foreign bodies, tumor formation, infections, subglottic stenosis, and airway edema, as well as a result of laryngomalacia, subglottic hemangioma, and vascular rings compressing the trachea. Stridor is usually diagnosed on the basis of symptoms and physical examination, with a view to revealing the underlying problem or condition. Chest and neck X-rays, CT scans, and/or MRIs may reveal structural pathology. Flexible fiberoptic bronchoscopy can also be very helpful, especially in assessing vocal cord function or in looking for signs of compression or infection. Heliox administered with a nonrebreathing face mask should be readily available in every operating room suite to assist in the treatment of stridor.

This chapter presents a commentary on the lung-specific complications following transplantation and this should be used to drive the investigation plan and management. Shared care protocols with effective communication should be organized in patients who live at a distance from the transplant center to ensure that local follow-up includes monitoring of the lung function and imaging. Acute rejection can be identified on lung biopsies obtained via transbronchial biopsy (TBBx) at fiberoptic bronchoscopy. Many transplant centers perform regular bronchoscopy and TBBx in addition to spirometry in the first year to enable early diagnosis and treatment of asymptomatic rejection, with the aim of preserving graft function and protecting against bronchiolitis obliterans syndrome (BOS). Recently the importance of detecting early, subclinical BOS before irreversible fibroproliferative disease has become established has been recognized, and a new stage of BOS 0-p has been added.