Stridor: Management and Treatment Options

Stridor is a high-pitched, wheezing sound resulting from turbulent airflow through a narrowed or obstructed upper airway. It is often a symptom of an underlying respiratory condition and can indicate serious airway compromise.

Causes of Stridor

Stridor can be caused by various conditions affecting the larynx, trachea, or bronchi. Some common causes include:

• Croup: Viral infection causing inflammation of the larynx and trachea.
• Laryngomalacia: Congenital softening of the laryngeal tissues, leading to airway collapse.
• Epiglottitis: Life-threatening bacterial infection of the epiglottis causing severe airway obstruction.
• Foreign body aspiration: Inhalation of objects, leading to obstruction of the airway.

Clinical Presentation

Patients with stridor may exhibit the following symptoms:

• Inspiratory stridor (upper airway obstruction)
• Expiratory stridor (lower airway obstruction)
• Severe respiratory distress
• Cyanosis in critical cases

Management and Treatment Options

Immediate Intervention

Acute stridor requires urgent assessment and management to prevent respiratory failure:

• Ensure airway patency and administer supplemental oxygen.
• Perform endotracheal intubation if necessary.
• Administer racemic epinephrine for airway inflammation.
• Use corticosteroids to reduce airway swelling.

Long-Term Treatment

Management varies based on the underlying cause:

• For croup: Supportive care and dexamethasone.
• For laryngomalacia: Surgical intervention like supraglottoplasty.
• For epiglottitis: Broad-spectrum antibiotics and airway protection.
• For foreign body aspiration: Bronchoscopy for removal.

Conclusion

Stridor is a significant clinical sign that requires careful evaluation and prompt treatment. Early intervention improves outcomes and prevents life-threatening complications.