Stridor

Overview Of Stridor

Stridor is a high-pitched, wheezing sound caused by disrupted airflow due to a partial obstruction in the upper airway, which includes the larynx, trachea, or pharynx. It is most commonly heard during inspiration but can also occur during expiration or both phases of breathing, depending on the location and severity of the obstruction. Stridor is a clinical sign rather than a disease itself and often indicates an underlying condition that requires prompt medical attention. It is more prevalent in children due to their narrower airways but can occur in adults as well. Stridor can be acute or chronic, and its characteristics (timing, pitch, and loudness) provide clues to the underlying cause.

Causes of Stridor

• Stridor can result from a variety of congenital, infectious, inflammatory, or traumatic conditions. In children, common causes include croup (laryngotracheobronchitis), foreign body aspiration, and congenital anomalies such as laryngomalacia or subglottic stenosis. In adults, causes may include tumors, vocal cord paralysis, or infections like epiglottitis. Other potential causes include anaphylaxis, airway trauma, or external compression from goiters or masses. Acute stridor is often due to infections or foreign bodies, while chronic stridor may indicate structural abnormalities or progressive diseases like tumors.

Risk Factors of Stridor

• Risk factors for stridor vary by age and underlying cause. In children, risk factors include a history of prematurity, congenital airway abnormalities, and exposure to respiratory infections. In adults, risk factors include smoking, chronic respiratory conditions, and a history of neck surgery or radiation therapy. Immunocompromised individuals are at higher risk for infections that can cause stridor, such as epiglottitis or abscesses. Additionally, individuals with a history of allergies or anaphylaxis are at risk for acute stridor due to airway swelling.

Prevention of Stridor

• Prevention of stridor involves addressing its underlying causes. Vaccination against infections like *Haemophilus influenzae* type b (Hib) and diphtheria can reduce the risk of epiglottitis and croup. Avoiding exposure to allergens and carrying an epinephrine auto-injector can prevent stridor due to anaphylaxis. In children, ensuring a safe environment free of small objects can prevent foreign body aspiration. Regular medical check-ups and prompt treatment of respiratory infections or chronic conditions can also reduce the risk of stridor.

Prognosis of Stridor

• The prognosis for stridor depends on the underlying cause and the timeliness of intervention. Acute causes, such as infections or foreign bodies, often resolve completely with appropriate treatment. Chronic conditions, such as tumors or congenital abnormalities, may require ongoing management and have a more variable prognosis. Early diagnosis and treatment are critical to preventing complications like respiratory failure or permanent airway damage. In most cases, addressing the underlying condition leads to a favorable outcome.

Complications of Stridor

• Complications of stridor can be life-threatening if not managed promptly. Severe airway obstruction can lead to respiratory failure, hypoxia, and even death. Prolonged stridor may cause secondary infections, such as pneumonia, due to impaired airway clearance. Chronic stridor can result in long-term damage to the airway, including scarring or stenosis. In children, untreated stridor can lead to developmental delays due to chronic hypoxia. Early intervention is essential to minimize these risks.

Related Diseases of Stridor

• Stridor is closely related to conditions affecting the upper airway, such as croup, epiglottitis, and laryngomalacia. It is also associated with lower airway diseases like asthma and bronchiolitis, though these typically cause wheezing rather than stridor. Other related conditions include vocal cord dysfunction, tracheal stenosis, and tumors of the larynx or trachea. Understanding these relationships is essential for accurate diagnosis and effective management of stridor.

Treatment of Stridor

Treatment of stridor depends on the underlying cause and the severity of the airway obstruction. In acute cases, such as anaphylaxis or croup, immediate interventions like epinephrine, corticosteroids, or nebulized adrenaline may be required to reduce swelling and improve airflow. Foreign body aspiration requires prompt removal, often via bronchoscopy. For chronic conditions like tumors or structural abnormalities, surgical intervention may be necessary. Oxygen therapy and intubation or tracheostomy may be required in severe cases to secure the airway. Addressing the root cause is essential for long-term management.