Stridor is an abnormal noise caused by partial airway obstruction. The document discusses different types of stridor and common causes of stridor in children, including croup (laryngotracheobronchitis), epiglottitis, and spasmodic croup. Croup most often affects children ages 3 months to 3 years and is caused by influenza viruses. Epiglottitis typically affects children ages 3 to 6 years and can cause drooling, muffled voice, and stridor. Management of airway obstruction may include oxygen, humidification, steroids, nebulizers, and intubation or tracheostomy in severe cases.

1. Stridor
Turbulent flow due to partial obstruction of the air way gives rise abnormal noise is called Stridor.
A) Wheezing –Bronchial Asthma
B) High pitched noise from Larynx or Trachea is called Stridor.
C) Low pitched noise from Nose ,Oropharynx& Supraglottic Larynx is called stertor.
Management of Acute Air way obstruction.
A) Assessment of suspected Laryngotrachea bronchitis/ Foreign body inhalation.Rx Intubation>
Tracheostomy.
B) O2
C) Humidification
D) Drugs- Steroid Dexamethasone
E) Nebulizer
F) L-epinephrine (5ml of 1:1000) or Racemic epinephrine (.5ml) Should be considered for
children with croup who have moderate to severe distress.
Acute Laryngeal infections
Laryngeal infection in childhood causes airway obstruction of which cardial symptom is Stridor,
Croup Combination of stridor hoarseness &typical barking cough 90% of cases of acute airway
obstruction in children.
Commonest Cause of Stridor
1)Acute laryngotrachealbronchitis(croup) 90% cases
2)Epiglotitis
3)spasmodic croup
4)Retropharyngeal abscess
5)Angioneurotic odema

2. 6) Ca- Larynx
7)Acute laryngeal Trauma
8) Foreign body aspiration.
CROUP(Acute Laryngotracheobronchitis)
3 months to3yrs.
Influenza virus Type A& B
Self limiting diseases
50% children improved within 24hrs of the onset of symptom.
X-ray shows Pencil tip or Steeple Sign (tracheal air column)
Inflammatory change throughout the airway in croup. Stridor due to odema in the subglottis.
Rx Nebulised epinephrine 1ml in 3ml normal saline& steroid.
Spasmodic Croup
Some Children appear to be prone to recurrent croup like symptom ,suddenly often at night &
resolved after a few hrs, Attack may be precipitated by GERD.or low IgA later developed Asthma.
Rx simple Dexamethasone.
ACUTE EPIGLOTTITIS
Stridor /muffled voice/ Drooling
3 to 6 yrs ,winter &spring season
When acute Epiglottitis is suspected Pharyngeal examination should nt be attempted.Tongue
depression may precipitate acute airway obstruction.But Fibreoptic &Rigid endoscope can assist the
diagnosis.
Gross Erythaema & odema of Supraglottc structure.
X-ray neek lateral view shows thickened oedematous Epiglotis> thump sign.
RX Ampicillin 50% resistance,3rd generation cephalosporin

3. Rifampicin prophylaxis to eradicate the carrier state Who are 4yrs or younger.
Nasotracheal intubation (usually less than 48hrs ) Nasotracheal rather orotracheal Route is
preferred. Systemic steroid administered 6hrs prior to removal of the tube will minimize post
intubation oedema.
Nebulised epidrine can assist with airway patence after extubation.
If more than 48hrs .ulceration >stenosis.
Tracheaostomy is not now considered first.