The document outlines stridor's causes, clinical features, differential diagnosis, investigations, treatments, complications, and prognosis, emphasizing the assessment of respiratory distress. Stridor is characterized by high-pitched sounds from airflow turbulence due to airway obstruction and has various causes ranging from congenital issues to infections. Management strategies are discussed, including proper nutrition for anatomical defects, medications for infections, and surgical interventions for specific conditions.

1. STRIDOR

2. HOW TO WRITE & REMEMBER
• CAUSES
• CLINICAL FEAUTRES
• DIFFRENTIAL DIAGNOSIS
• INVESTIGATION
• TREATMENT
• COMPLICATIONS
• PROGNOSIS

3. Assessment of Respiratory Distress
(SpO2) ≤94% on room air indicates hypoxemia.
• Signs of tissue hypoxia:
• Tachycardia (early)
• Tachypnea
• Nasal flaring, retractions
• Agitation, anxiety, irritability
• Cyanosis (late)
• Decreased level of consciousness (late)
• Bradypnea, apnea (late)

4. INVESTIGATIONS
• CHEST XRAY
• PULMONARY FUNCTION TEST
• CBC, CRP / PROCALCITONIN, BLOOD C/S
• BRONCHOSCOPY
• BLOOD GAS ANALYSIS
• CT CHEST
• OTHERS

5. • A stridor is a high-pitched sound produced by
airflow turbulence through a partially
obstructed airway involving the supraglottis,
glottis, subglottis, or trachea.

6. LOCALIZATION
1.Inspiratory stridor- Localizes to the
supraglottis
2.Biphasic stridor- Localizes to the glottis or the
sub-glottis
3.Expiratory stridor- Localizes to the trachea

7. CAUSES
CONGENITAL ACQUIRED
NASAL Choanal atresia/stenosis Polyposis
NASOPHARYNX
Mid-face hypoplasia
(Pfeiffer, Crouzon)
Pharyngomalacia
Adenoidal hypertrophy
Juvenile Nasopharyngeal Angioma
Encephalocele
ORAL CAVITY
Micrognathia
(Pierre-Robin Sequence)
Macroglossia (Downs,
Beckwith-Wiedmann)
Tonsillar Hypertrophy
Retropharyngeal Abscess
LARYNX
Vallecular Cyst
Laryngomalacia
Lingual Thyroid
Epiglottitis
GLOTTIS Laryngeal Web
Vocal Cord Dysfunction
Vocal Cord Palsy
Juvenile onset Recurrent Resp
Papillomatosis Foreign Body
SUBGLOTTIS
Congenital Subglottic
Stenosis Subglottic
Hemangioma
Post Intubation Subglottic Stenosis
Croup
Angioedema (Allergic/Hereditary)
Trachea
Tracheomalacia
Vascular Ring
Foreign Body Bacterial
Tracheitis
Post Intubation Stenosis

8. Laryngomalacia
• the most common cause of stridor in an infant
• is inspiratory,
• typically worsens by 4-6 weeks,
• Increases with exertion being relatively silent at
rest and/or in a prone position.
• the first presentation, is often misdiagnosed as
a croup,

9. • Laryngomalacia is generally a benign condition that
typically gets noticed at 2-4 weeks,
• it progresses over the next 2-4 weeks, and
• stabilizes for 1-2 months after which the intensity of the
sounds starts to decrease
Red flags
• onset at birth, facial dysmorphism,poor weight gain, prior
history of intubation, hypophonia/ Aphonia , recurrent
apneic events, or an acute life threatening event

10. Inv
• flexible bronchoscopy or a laryngoscopy is the
gold standard investigation for confirmation of
anatomical pathologies of the airway

11. T/T
• For anatomical defects such as laryngomalacia
proper nutritive care is important so that
adequate weight gain can be achieved.
• GER is a common association observed in as
much as 64%
• Anti-reflux measures
• Supraglotoplasty

12. Croup
• Acute Laryngo-tracheobronchitis
• typically occurring in children 6months-3years
following a febrile illness

13. Inv
• Chest X-ray is the most commonly performed
• The steeple sign, considered specific for
croup, indicated edema/ obstruction of the
subglottis and
• can be seen in any subglottic pathologies.

14. T/T
• Neb Adrenaline,
• Oral/Neb steroids

15. CONDITION TREATMENT
ACUTE
Croup Neb Adrenaline, Oral/Neb steroids
Epiglottitis Antibiotics
Foreign Body Aspiration Bronchoscopic Retrieval
Retro/Parapharyngeal Abscess Antibiotics +/- Surgical Drainage
Allergic Angioedema Antihistamines, steroids, aderenaline
Hereditary Angioedema FFP, C1 esterase inhibitors
CHRONIC
Choanal Atresia Trans nasal Surgery + Stenting
Adeno-Tonsillar Hypertrophy Adenotonsillectomy
Vallecular cyst Marsupialization or excision
Laryngomalacia Anti-reflux measures, Supraglotoplasty
Sub Glottic Hemangioma Propranolol, Sirolimus, Intralesional Ste-
roid, Laser Excision
Vocal Cord Palsy Unilateral- Conservative
Bilateral- Tracheostomy
Sub Glottic Stenosis Balloon Dilatation, Laryngo Tracheal
Reconstruction
Tracheomalacia Ipratropium/Tiotropium inhalation,
CPAP Therapy, Aortopexy

16. • T/T-
• 1.ANTIBIOTICS- ampicillin, coamoxiclav, 2nd
or
3rd
gen cephalosporin,Linazolid, vancomycin ,
clindamycin, Azithromycin
• 2. PARACETAMOL
• 3. FLUID INTAKE
• 4. MAINTAINING NUTRITION

17. THANKYOU