Stridor

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

Differential Diagnosis

Trauma

1. Larynx fracture
2. Tracheobronchial tear/injury
3. Thyroid gland injury/trauma
4. Trachea injury
5. Electromagnetic, Physics, trauma, Radiation Causes
6. Burns, inhalation

Infectious Disorders

1. Bacterial tracheitis
2. Diphtheria
3. Tetanus
4. Tracheobronchial Tuberculosis
5. Poliomyelitis, paralytic, bulbar
6. Poliomyelitis, acute
7. Fungal Laryngitis

Abscesses

1. Abscess, parapharyngeal
2. Epiglottitis, acute
3. Peritonsillar abscess
4. Laryngotracheobronchitis, acute
5. Retropharyngeal Abscess

Neoplastic Disorders

1. Neoplasms/tumors

Allergic and Auto-Immune Disorders

1. Croup, spasmodic/tracheobronchitis
2. Angioedema/Angioneurotic edema

Metabolic, Storage Disorders

1. Cerebral Gaucher's of infants (acute)
2. Tracheobronchial amyloidosis

Biochemical Disorders

1. Tetany

Congenital, Developmental Disorders

1. Angioedema/Angioneurotic edema, hereditary

Psychiatric Disorders

1. Somatization disorder

Anatomical or Mecanical

1. Foreign Body Aspiration
2. Acute gastric acid/aspiration syndrome
   1. Airway obstruction
   2. Neck compartment hemorrhage/hematoma

Vegetative, Autonomic, Endocrine Disorders

1. Esophageal free reflux/GERD syndrome
2. Laryngospasm, acute
   1. Bilateral vocal cord paralysis
3. Hypoparathyroidism

Poisoning

1. 1. Smoke inhalation
   2. Chemical burn/esophagus

See Also

Stridor (Peds)