Stridor

Question 1

What is stridor?

Answer 1

Stridor is a high-pitched inspiratory sound indicating either dynamic or fixed extrathoracic airway obstruction (i.e. above the thoracic inlet/upper trachea).

When it arises acutely and is associated with respiratory distress, stridor requires immediate attention.

Question 2

What is stertor?

Answer 2

Stertor is a lower-pitched inspiratory sound associated exclusively with the nasopharynx (e.g. snoring).

Question 3

Give differentials for stridor

Note: nose and nasopharynx

Answer 3

• Congenital obstruction
  
  • Choanal atresia (rare)
• Inflammation
  
  • Rhinitis and sinusitis (common)

Question 4

Give differentials for stridor

Note: mouth, oropharynx and hypopharynx

Answer 4

• Congenital obstruction
  
  • Macroglossia and glossoptosis (rare)
• Inflammation
  
  • Tonsillar hypertrophy (common)
• Masses
  
  • Cystic hygroma or other malformation (rare)

Question 5

Give differentials for stridor

Note: larynx

Answer 5

• Congenital obstruction
  
  • Laryngomalacia (common), laryngeal web or cleft, vocal cord paralysis (rare)
• Inflammation
  
  • GOR (rare)
• Infection
  
  • Croup (common) and acute epiglottitis (very rare post-immunisation)
• Masses
  
  • Haemangiomas and abscess (rare)
• Acquired obstruction
  
  • Subglottic stenosis (common) and foreign inhalation (rare, but must not be missed)

Question 6

Give differentials for stridor

Note: trachea

Answer 6

• Congenital obstruction
  
  • Tracheomalacia and tetralogy of fallot (rare)
• Infection
  
  • Bacterial tracheitis (rare)