From the Guidelines
Stridor is typically caused by an obstruction in the upper airway, which can be due to various factors such as laryngeal edema 1, infantile hemangioma 1, or other conditions that affect the airway.
Common Causes of Stridor
- Laryngeal edema, which can occur after extubation 1
- Infantile hemangioma, particularly those that involve the subglottic area 1
- Other airway obstructions, such as foreign bodies or tumors
Clinical Presentation
Stridor is characterized by a high-pitched sound that occurs during breathing, and it can be accompanied by other symptoms such as biphasic stridor and barky cough 1. The severity of stridor can vary, and it is essential to assess the patient's airway, breathing, and circulation (ABCs) closely.
Diagnosis and Management
Diagnosis of the underlying cause of stridor is crucial, and it may involve endoscopy, imaging studies, or other diagnostic tests. Management of stridor depends on the underlying cause and may include medical therapy, such as corticosteroids or propranolol, or surgical intervention, such as endoscopic laser ablation or surgical excision 1. In cases of severe respiratory distress, oxygen therapy and racemic epinephrine may be necessary to help reduce airway edema 1. Consulting a specialist, such as an otolaryngologist or a pulmonologist, may be necessary for further evaluation and management.
From the Research
Causes of Stridor
- Stridor is caused by abnormal air passage into the lungs, which can be due to obstruction located anywhere in the extra-thoracic or intra-thoracic airway 2
- The most common cause of acute stridor is laryngotracheal inflammation (croup), while laryngotracheomalacia is the most common cause of congenital, chronic stridor 2
- Stridor can also be caused by noninfectious and/or congenital conditions, as well as life-threatening etiologies 3
- Congenital anomalies, such as supraglottic or glottic obstruction, can cause stridor, which may exist from birth or develop within days, weeks, or months 4
- Acquired disorders, such as obstruction or collapse of the laryngotracheal airway, can also produce stridor, which may be severe and potentially life-threatening 5
Types of Stridor
- Stridor can be congenital or acquired, acute, intermittent, or chronic 2
- Congenital stridor can be caused by various conditions, including laryngotracheomalacia, and requires a team-based, interdisciplinary approach for diagnosis and management 6
- Acquired stridor can be caused by conditions such as croup, and requires prompt recognition and treatment to prevent complications 3
Diagnosis and Management
- The diagnosis of stridor requires a thorough history, physical examination, and radiological examination, as well as endoscopic assessment and sometimes imaging 2, 4, 5
- Treatment of stridor should be individualized, considering the patient's overall condition, stridor etiology, and impact on breathing and swallowing, and may include observation, non-pharmacological measures, local or systemic medications, endoscopic and open surgeries, or a temporary or long-term tracheostomy 5