What is stridor?
Stridor is a high-pitched sound that is usually heard best when a child breathes in (inspiration). It is usually caused by an obstruction or narrowing in your child's upper airway. The upper airway consists of the following structures in the upper respiratory system:
Sinuses. Cavities, or air-filled pockets, that are near the nasal passage. While present at birth, the sinuses are small and filled with fluid. They begin to grow in size and fill with air at different rates.
Ethmoid sinus. This sinus is located inside the face, around the area of the bridge of the nose. It is present at birth, and continues to grow until about age 12.
Maxillary sinus. This sinus is located inside the face, around the area of the cheeks. It also continues to grow until about age 12.
Frontal sinus. This sinus is located inside the face, in the area of the forehead. It begins to develop between ages 1 and 2 years, but is not fully formed until adolescence.
Sphenoid sinus. This sinus is located deep in the face, behind the nose. It begins to develop between 2 and 3 years of age, but does not fully develop until late adolescence.
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Larynx. Also known as the voice box, the larynx is a cylindrical grouping of cartilage, muscles, and soft tissue which contains the vocal cords. The vocal cords are the upper opening into the windpipe (trachea), the passageway to the lungs.
Trachea (windpipe). A tube that reaches from the voice box to the bronchi in the lungs.
The sound of stridor depends on location of the obstruction in the upper respiratory tract. Usually, the stridor is heard when the child breathes in (inspiration), but can also be heard when the child breathes out (expiration).
What are the causes of stridor?
There are many different causes of stridor. Some of the causes are diseases, while others are problems with the anatomical structure of the child's airway. The upper airway in children is shorter and narrower than that of an adult, and, therefore, more likely to lead to problems with obstruction. The following are some of the more common causes of stridor in children:
How is stridor diagnosed?
Stridor is usually diagnosed solely on the medical history and physical examination of your child. It is important to remember that stridor is a symptom of some underlying problem or condition. If your child has stridor, your child's health care provider may order some of the following tests to help determine the cause of the stridor:
Chest and neck X-rays. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
CT Scan or MRI. These are more detailed studies of the internal organs and may be necessary to examine the anatomy of the chest and neck.
Bronchoscopy. Congenital, chronic, or severe stridor may require direct visualization of the airways with a flexible fiberoptic bronchoscope. This procedure is under sedation and local anesthesia, and may be performed on an outpatient, as well as an inpatient basis.
Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. To obtain this measurement, a small sensor (like a Band-Aid) is taped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
Sputum culture. A diagnostic test performed on the material that is coughed up from the lungs and into the mouth. A sputum culture is often performed to determine if an infection is present.
What Is the treatment for stridor?
Specific treatment of stridor will be determined by your child's health care provider based on:
Your child's age, overall health, and medical history
Cause of the condition
Extent of the condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment may include:
Referral to an ear, nose, and throat specialist (otolaryngologist) for further evaluation (if your child has a history of stridor)
Medications by mouth or injection (to help decrease the swelling in the airways)
Hospitalization and emergency surgery may be necessary depending on the severity of the stridor.
Last Reviewed Date: 09/15/2014
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