This document discusses stridor, which is a noisy respiration caused by turbulent airflow through a narrowed airway. It defines three types of stridor based on where in the respiratory cycle the noise occurs: inspiratory, expiratory, and biphasic. Common causes of stridor in children include infections like croup as well as foreign objects. Diagnosis involves examining the timing, quality and other characteristics of the noise along with imaging tests to find the specific obstruction. Treatment depends on the underlying cause but may include medications to reduce swelling like steroids or racemic adrenaline to ease breathing.

1. STRIDOR

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. 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. Types Of Stridor And Probable Site of Obstruction

5. Common Causes Of Stridor In Children & Infants

7. Diagnosis Of Stridor In Children

8. Diagnosis Of
Stridor In Children
Part - 2

10. 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

11. 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.

12.  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

13. 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.

14. 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.

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