Noisy Breathing

Stridor is defined as the presence of high pitched noisy breathing that occurs due to partial obstruction of the airways at the level of the voice box (larynx) or below it, in the wind pipe (trachea).

This must be differentiated from ‘stertor’ which is a low pitched sound due to partial airway obstruction above the level of the voice box, i.e. nose, mouth or throat.

Significant airway obstruction can lead to respiratory distress and could be a medical emergency. Some children may fail to thrive (poor growth) due to the increased work of breathing and difficulty in feeding.

A detailed evaluation must be carried out by the Paediatric ENT surgeon as there are numerous causes of stridor in children. Some of the commoner conditions are Laryngomalacia, Vocal cord paralysis, Subglottic stenosis, hemangioma, respiratory papillomata or Tracheomalacia.

X-rays and CT scanning may be helpful in determining the cause. The definitive modality for evaluation is by doing an endoscopy of the airway, ie Laryngoscopy and bronchoscopy. A flexible fiberoptic laryngoscopy may be perfomed in the OPD under local anaesthesia / sedation or under general anaesthesia in the operation theatre.

The management depends entirely on the cause and severity of the stridor and may include medication, oxygen supplementation, supportive ventilation or surgical management.

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