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Stridor

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A topic of ENT , explaining in details about 'stridor' a symtopm.

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Stridor

  1. 1. STRIDOR
  2. 2. DEFINATION  Stridor is noisy respiration produced by turbulent air flow through the narrowed air passages. It may be heard during inspiration, expiration or both.
  3. 3. TYPES OF STRIDOR  INSPIRATORY STRIDOR – It is often produced in obstructive lesions of supraglottis or pharynx.  EXPIRATORY STRIDOR - It is produced in lesions of thoracic trachea, primary and secondary bronchi.  BIPHASIC STRIDOR - It is seen in lesions of glottis, subglottis and cervical trachea.
  4. 4. Types Of Stridor And Probable Site of Obstruction
  5. 5. Common Causes Of Stridor In Children & Infants
  6. 6. Diagnosis Of Stridor In Children
  7. 7. Diagnosis Of Stridor In Children Part - 2
  8. 8. MANAGEMENT  Stridor is a physical sign not a disease.  Stridor is usually diagnosed on the basis of history and physical examination, with a view to revealing the underlying problem or condition.  Attempt should always be made to discover the cause. It is important to elicit :  Time of onset  Mode of onset  Duration  Cyanotic spells  Aspiration or ingestion of a foreign body  Laryngeal Trauma
  9. 9. PHYSICAL EXAMINATION  Stridor is always associated with respiratory distress. There may be recession in Suprasternal Notch, Sternum, Intercostal Spaces & Epigastrium during inspiratory efforts.  Note whether the stridor is inspiratory, expiratory or biphasic. Which indicates probable site of obstruction.
  10. 10.  Snoring or snorting – Nasal Or Nasopharyngeal cause.  Gurgling sound and muffled voice - Pharyngeal Cause.  Horse cry or voice – Laryngeal Cause  Expiratory wheeze – Bronchial Obstruction  Associated fever – Infection ex: Acute Laryngitis ASSOCIATED CHARACTERISTICS OF STRIDOR
  11. 11. RADIOGRAPHY  X-ray of chest and soft tissue neck both anteroposterior and lateral views.  Fluoroscopy to see chest movements both during inspiration and expiration.  Tomography of chest for mediastinal mass.  Angiography , if aberrant vessels are suspected  CT scan/MRI.
  12. 12. TREATMENT  Once the diagnosis has been made treatment of exact cause can be made.  Use of nebulized racemic adrenaline epinephrine in cases where airway edema may be the cause of the stridor.  Use of dexamethasone.  Use of inhaled Heliox (70% helium, 30% oxygen); the effect is almost instantaneous. Helium, being a less dense gas than nitrogen, reduces turbulent flow through the airways.  Some conditions (ex: epiglottitis, bacterial tracheitis) may require antibiotics, while steroids may be useful in other situations.
  13. 13. THANK YOU

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