Stridor

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Background

  • Stridor refers to harsh upper airway sounds, classically inspiratory

Clinical Features

  • Inspiratory stridor
    • Suggestive of extrathoracic obstruction (Pressuretrach < Pressureatm)
    • Croup, metapneumovirus, FB, epiglottitis
  • Expiratory stridor vs. wheezing
    • Suggestive of intrathoracic obstruction (Pressuretrach < Pressurepleura)
    • Asthma, bronchiolitis

Differential Diagnosis

Stridor

Trauma

  • Larynx fracture
  • Tracheobronchial tear/injury
  • Thyroid gland injury/trauma
  • Trachea injury
  • Electromagnetic or radiation exposure
  • Burns, inhalation

Infectious Disorders

Abscesses

Neoplastic Disorders

  • Neoplasms/tumors

Allergic and Auto-Immune Disorders

Metabolic, Storage Disorders

  • Cerebral Gaucher's of infants (acute)
  • Tracheobronchial amyloidosis

Biochemical Disorders

  • Tetany

Congenital, Developmental Disorders

Psychiatric Disorders

  • Somatization disorder

Anatomical or Mecanical

  • Foreign Body Aspiration
  • Acute gastric acid/aspiration syndrome
    • Airway obstruction
    • Neck compartment hemorrhage/hematoma

Vegetative, Autonomic, Endocrine Disorders

  • Esophageal free reflux/GERD syndrome
  • Laryngospasm, acute
    • Bilateral vocal cord paralysis
  • Hypoparathyroidism

Poisoning

Chronic Pediatric Conditions

  • Laryngomalacia
  • Tracheomalacia[1]
  • Subglottic stenosis or prior intubation
  • Vascular ring (double aortic arch)
  • Vocal cord dysfunction/paroxysmal vocal fold movement

Evaluation

Management

  • Treat underlying cause

Disposition

  • Based on underlying cause

See Also

External Links

References

  1. Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004