Introduction

Stridor is an abnormal, harsh, high pitched, turbulent musical breathing sound caused by partial obstruction in the larynx/tracheobronchial tree and is usually associated with dyspnea. stridor indicates an emergency and should always evaluate immediately.¹ 

Stridor is an Emergency Condition. Its indicates an obstruction of the airway. Stridor in adult a manifestation of airway obstruction, due to growth larynx, larynx edema etc.

It is more common in males than females. Growth larynx was once one of the most common causes of airway obstruction. 

Early detection of stridor is very important to avoid the complications. Some symptoms such as Dyspnea, excessive use of respiratory muscles and intercostal recession are important warning signs that the airway obstruction is severe enough to compromise the airway ventilation.

There are several important signs and symptoms which a physician should look out for increasing severity of the airway obstruction. The warning signs of stridor are presence of drooling, tripod position, cyanosis, decreased conscious level, respiratory distress, silent chest, and episodes of apnoea.² 

It is important that a proper history taking and physical examination are the important key in assisting the physician in the diagnosing and management of stridor in the emergency department. Delay or misdiagnose the cause of the stridor may lead to mismanagement of the patient and causing very serious morbidity.³

1. Textbook of Ear, Nose, Throat and Head and Neck Surgery, P. Hazarika, 3^rd edition, page 654.
2. Majumdar S, Bateman NJ, Bull PD. Pediatric stridor. Arch Dis Child Educ Prac Ed 2006;91:101-105.
3. Mohamad N, Sjam'un A, Ismail F, Solayar LD, Mohamed SA et al. Acute stridor-diagnostic challenges in different age groups presented to the emergency department. Emergency Med Med 2012;2:125.
4. PL Dhingra, Shruti Dhingra. Disease of ear, nose and throat, 5th edition, Elsevier, Page 315.
5. Stridor in adult patients presenting from community: An Alarming clinical sign. Vasileios zochios, Aristotle D protopapas and Kamen valchanov. Journal intensive care soc.2015 aug;16(3):272-273.
6. Aetiological profile of paediatric laryngeal stridor in an indian hospital. VEDANTAM RUPA AND RAJAGOPALAN RAMAN. annuals of Tropical paediatrics (1991)11,137-141.
7. Stridor in children Waalkens HJ,et al Wouters b, Zwaaans-Hesselink AG, Gerritsen J. Ned Tijdschr Geneeskd.1989 oct 7;133(40):1981-4.

Dr Vinay Gangwani

Consultant ENT at Sachkhand Hospital Neemrana, Alwar Rajasthan