Etiology, Clinical Features, and Management of Stridor in Children

Introduction

Stridor in children is a high-pitched, wheezing sound caused by turbulent airflow through a narrowed upper airway. It can arise from congenital abnormalities, infections, or trauma and requires timely diagnosis and management to prevent severe respiratory complications.

Etiology

• Congenital Causes: Laryngomalacia, vocal cord paralysis, subglottic stenosis.
• Infectious Causes: Viral croup, epiglottitis, bacterial tracheitis.
• Traumatic or Other Causes: Foreign body aspiration, post-intubation stenosis, allergic reactions.

Clinical Features

Children with stridor may present with noisy breathing, respiratory distress, and varying degrees of hypoxia. Key signs to monitor include:

• Inspiratory stridor in supraglottic obstruction
• Expiratory stridor in subglottic involvement
• Biphasic stridor in severe upper airway compromise

Emergency Management

Initial assessment should focus on airway patency, breathing, and circulation. Emergency interventions include:

• Securing the airway via oxygen therapy, nebulized epinephrine, or corticosteroids
• Immediate intubation or tracheostomy in critical cases
• Addressing underlying causes such as infection or foreign body removal

Long-Term Interventions

Management strategies vary based on etiology but often include:

• Regular follow-up with pediatric otolaryngologists
• Surgical interventions for structural abnormalities
• Medical therapies including anti-inflammatory drugs and bronchodilators

Conclusion

Stridor in children is a significant clinical sign that requires immediate evaluation and appropriate management. By understanding its causes, clinical presentation, and emergency interventions, healthcare providers can ensure optimal patient outcomes.