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| Stridor | |
|---|---|
| Inspiratory and expiratory stridor in a 13-month child withcroup | |
| Specialty | Otorhinolaryngology,pediatrics |
Stridor (from Latin stridere 'to grate, screech') is an extra-thoracic high-pitchedbreath sound resulting fromturbulent air flow in thelarynx or elsewhere in theupper respiratory tract. It is different fromstertor, which is a snoring noise originating in thepharynx, andwheezing, which originates in thebronchi.
Stridor is a physical sign which is caused by a narrowed orobstructed airway. It can beinspiratory,expiratory orbiphasic, although it is usually heard during inspiration. Inspiratory stridor often occurs in children withcroup. It may be indicative of serious airway obstruction from severe conditions such asepiglottitis, a foreign body lodged in the airway, or a laryngeal tumor. Stridor should always command attention to establish its cause. Visualization of the airway by medical experts equipped to control the airway may be needed.
Stridor may occur as a result of:
Stridor is mainly diagnosed on the basis of history and physical examination, with a view to revealing the underlying problem or condition.
Chest and neckx-rays,bronchoscopy,CT-scans, and/orMRIs may reveal structural pathology.
Flexible fiberopticbronchoscopy can also be very helpful, especially in assessing vocal cord function or in looking for signs of compression or infection.
The first issue of clinical concern in the setting of stridor is whether or nottracheal intubation ortracheostomy is immediately necessary. A reduction in oxygen saturation is considered a late sign of airway obstruction, particularly in a child with healthy lungs and normal gas exchange. Some patients will need immediate tracheal intubation. If intubation can be delayed for a period, a number of other potential options can be considered, depending on the severity of the situation and other clinical details. These include:
In obese patients, elevation of thepanniculus has shown to relieve symptoms by 80%.
