Pediatric Stridor

Stridor can be caused by many things. These are some of the more common causes of stridor in children:

• Defects in the child’s nose and throat, larynx or trachea that the child was born with (congenital)
• Infections such as croup, epiglottitis, or tonsillitis and abscesses in the back of the throat
• Swallowing toxic substances
• Swallowing pieces of food or small objects that get caught in the upper airway
• Injuries to the jaw or neck

Other conditions may also cause stridor. For example, problems with the brain may interfere with normal breathing. Or an allergic reaction may cause swelling of the airways. And tumors may also block the airways.

Stridor is a noisy or high-pitched sound with breathing. It's a sign that the upper airway is partially blocked. It may involve the nose, mouth, sinuses, voice box (larynx) or windpipe (trachea).

The upper airway in a child is shorter and narrower than that of an adult. Because of this, a child is more likely to have problems with blockage of the airway.

The main symptom of stridor is the noise that is heard while your child breathes. The sound of stridor depends on where the blockage is in your child’s upper respiratory tract.

If your child has stridor that comes back, he or she may have trouble eating and drinking, and poor weight gain.

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The provider may refer you to an ear, nose and throat specialist (ENT). 

If your child has stridor, the healthcare provider may order tests to find the cause. The tests may include:

• X-rays. X-rays of the chest and neck may be done. 
• CT scan or MRI. These are more detailed studies of the internal organs. Your child may need these so the ENT can look at the anatomy of the chest and neck.
• Laryngoscopy. A special instrument is used to check the back of the throat and larynx. 
• Bronchoscopy. A special instrument is used to check the throat, larynx, trachea and tubes leading into the lungs (bronchi).
• Spirometry. This is an easy test that checks how much air is breathed in and out. It also measures how quickly the air is breathed out. It is difficult to test young children with spirometry.
• Pulse oximetry. An oximeter is a small tool that measures the amount of oxygen in the blood. A small sensor is placed on a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
• Sputum culture. A sample of the material (sputum) that is coughed up from the lungs is sent to the lab to check for infection.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider may simply watch and recheck your child for certain conditions that cause stridor. Treatment may include:

• Referral to an ear, nose and throat specialist (ENT)
• Surgery, if the stridor is severe
• Medicines by mouth or shots to help decrease the swelling in the airways or treat an infection
• Hospital stay and emergency surgery, depending on how severe the stridor is

If left untreated, stridor can block the child’s airway. This can be life-threatening or even cause death.

Call your child’s healthcare provider if your child makes a noisy or high-pitched sound while breathing.

Call 911 or get medical help right away if your child has signs or symptoms of severe blockage of the airway. These signs may include:

• Gasping for air, choking
• Nostrils widening when breathing
• Sinking in of the areas between the ribs when breathing
• Change in behavior
• Bluish-colored skin
• Loss of consciousness