A topic of ENT , explaining in details about 'stridor' a symtopm.

1. STRIDOR

2. DEFINATION
 Stridor is noisy respiration produced by
turbulent air flow through the narrowed air
passages. It may be heard during
inspiration, expiration or both.

3. TYPES OF STRIDOR
 INSPIRATORY STRIDOR – It is often
produced in obstructive lesions of
supraglottis or pharynx.
 EXPIRATORY STRIDOR - It is produced in
lesions of thoracic trachea, primary and
secondary bronchi.
 BIPHASIC STRIDOR - It is seen in lesions of
glottis, subglottis and cervical trachea.

4. Types Of Stridor And Probable Site of Obstruction

5. Common Causes Of Stridor In Children & Infants

7. Diagnosis Of Stridor In Children

8. Diagnosis Of
Stridor In Children
Part - 2

10. MANAGEMENT
 Stridor is a physical sign not a disease.
 Stridor is usually diagnosed on the basis of history
and physical examination, with a view to revealing
the underlying problem or condition.
 Attempt should always be made to discover the
cause. It is important to elicit :
 Time of onset
 Mode of onset
 Duration
 Cyanotic spells
 Aspiration or ingestion of a foreign body
 Laryngeal Trauma

11. PHYSICAL EXAMINATION
 Stridor is always associated with respiratory
distress. There may be recession in
Suprasternal Notch, Sternum, Intercostal
Spaces & Epigastrium during inspiratory
efforts.
 Note whether the stridor is
inspiratory, expiratory or biphasic. Which
indicates probable site of obstruction.

12.  Snoring or snorting – Nasal Or
Nasopharyngeal cause.
 Gurgling sound and muffled voice -
Pharyngeal Cause.
 Horse cry or voice – Laryngeal Cause
 Expiratory wheeze – Bronchial Obstruction
 Associated fever – Infection ex: Acute
Laryngitis
ASSOCIATED CHARACTERISTICS OF STRIDOR

13. RADIOGRAPHY
 X-ray of chest and soft tissue neck both
anteroposterior and lateral views.
 Fluoroscopy to see chest movements both
during inspiration and expiration.
 Tomography of chest for mediastinal mass.
 Angiography , if aberrant vessels are
suspected
 CT scan/MRI.

14. TREATMENT
 Once the diagnosis has been made treatment of
exact cause can be made.
 Use of nebulized racemic adrenaline epinephrine in
cases where airway edema may be the cause of the
stridor.
 Use of dexamethasone.
 Use of inhaled Heliox (70% helium, 30% oxygen); the
effect is almost instantaneous. Helium, being a less
dense gas than nitrogen, reduces turbulent flow
through the airways.
 Some conditions (ex: epiglottitis, bacterial tracheitis)
may require antibiotics, while steroids may be useful
in other situations.

15. THANK YOU