Stridor: Difference between revisions
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**If stable consider imaging with video laryngoscope [[GEMC:Airway Procedures]] | **If stable consider imaging with video laryngoscope [[GEMC:Airway Procedures]] | ||
***CT of neck can be considered if mass/infection suspected but not dynamic like laryngoscope | ***CT of neck can be considered if mass/infection suspected but not dynamic like laryngoscope | ||
*Inspiratory stridor | *Inspiratory stridor | ||
*Expiratory stridor vs. wheezing | **Suggestive of extrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>atm</sub>) | ||
**Croup, metapneumovirus, FB, epiglottitis | |||
*Expiratory stridor vs. wheezing | |||
**Suggestive of intrathoracic obstruction (Pressure<sub>trach</sub> < Pressure<sub>pleura</sub>) | |||
**Asthma, bronchiolitis | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 01:58, 17 September 2015
Intial Work-Up
- Assess stability of airway
- If unstable, see Difficult Airway Algorithm, see Intubation and consider surgical intervention/consultation
- If stable consider imaging with video laryngoscope GEMC:Airway Procedures
- CT of neck can be considered if mass/infection suspected but not dynamic like laryngoscope
- Inspiratory stridor
- Suggestive of extrathoracic obstruction (Pressuretrach < Pressureatm)
- Croup, metapneumovirus, FB, epiglottitis
- Expiratory stridor vs. wheezing
- Suggestive of intrathoracic obstruction (Pressuretrach < Pressurepleura)
- Asthma, bronchiolitis
Differential Diagnosis
Stridor
Trauma
- Larynx fracture
- Tracheobronchial tear/injury
- Thyroid gland injury/trauma
- Tracheal injury
- Electromagnetic or radiation exposure
- Burns, inhalation injury
Infectious Disorders
- Bacterial tracheitis
- Diphtheria
- Tetanus
- Tracheobronchial tuberculosis
- Poliomyelitis, paralytic, bulbar, or acute
- Fungal laryngitis
Abscesses
- Retropharyngeal abscess
- Epiglottitis, acute
- Peritonsillar abscess
- Laryngotracheobronchitis (croup)
- Retropharyngeal abscess
Neoplastic Disorders
- Neoplasms/tumors
Allergic and Auto-Immune Disorders
- Spasmodic/tracheobronchitis
- Angioedema/Angioneurotic edema
Metabolic, Storage Disorders
- Cerebral Gaucher's of infants (acute)
- Tracheobronchial amyloidosis
Biochemical Disorders
Congenital, Developmental Disorders
- Angioedema/Angioneurotic edema, hereditary
Psychiatric Disorders
- Somatization disorder
Anatomical or Mechanical
- Foreign body aspiration
- Acute gastric acid/aspiration syndrome
- Airway obstruction
- Neck compartment hemorrhage/hematoma
- Paradoxical vocal fold motion [1]
Vegetative, Autonomic, Endocrine Disorders
- Esophageal free reflux/GERD syndrome
- Laryngospasm, acute
- Bilateral vocal cord paralysis
- Hypoparathyroidism
Poisoning
Chronic Pediatric Conditions
- Laryngotracheomalacia[2]
- Subglottic stenosis or prior intubation
- Vascular ring (double aortic arch)
- Vocal cord dysfunction/paroxysmal vocal fold movement
See Also
- ↑ Vocal Cord Dysfunction on Internet Book of Critical Care https://emcrit.org/ibcc/vcd/
- ↑ Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004