Etiology, Clinical Profile, Evaluation, and Management of Stridor in Children

Indian J Pediatr. 2021 Nov;88(11):1115-1120. doi: 10.1007/s12098-021-03722-8. Epub 2021 Mar 17.

Abstract

Objective: To evaluate various causes of pediatric stridor and their management among admitted patients in last 2 y.

Methods: Retrospective study of 67 stridor cases in pediatric age group (from birth to 18 y), admitted to the Department of Pediatrics and ENT (Ear, Nose and Throat) from May 2018 to April 2020 were included in the study. Data were obtained from medical records regarding age, gender, clinical presentation, and management.

Results: Out of 67 cases of pediatric stridor, 28.3% were infants, 50.7% were between 1 to 5 y, while 20.9% were between 5 to 18 y. Foreign body trachea (FB) was the most common (38.8%) cause of stridor. The commonest cause of stridor among infants was laryngomalacia (47.4%) while FB trachea (55.9%) was the commonest cause among 1 to 5 y age group. In age group between 5 to 18 y, peritonsillar abscess and bacterial tracheitis (21.4% each) were found to be the most common. Primary management with securing of airways were done in all cases. Curative treatment was provided according to the underlying pathology. Eight patients (11.9%) required tracheostomy to bypass airway obstruction. There was no mortality in the present study population.

Conclusion: Pediatric stridor management is a teamwork between ENT surgeons, pediatricians, and anaesthetists. Management starts with suspicion from history followed by clinical and radiological evaluation. Securing airway is of utmost importance and precise management of cause is carried out later.

Keywords: Fiberoptic laryngoscopy; Laryngomalacia; Stridor; Tracheostomy.

MeSH terms

  • Airway Obstruction* / diagnosis
  • Airway Obstruction* / etiology
  • Airway Obstruction* / therapy
  • Child
  • Humans
  • Infant
  • Respiratory Sounds / diagnosis
  • Respiratory Sounds / etiology
  • Retrospective Studies
  • Tracheal Diseases*
  • Tracheostomy