Stridor (peds)

Diagnosis

1. Supraglotic Expiratory Gurgling
2. Glottic Biphasic (larynx-vocal cords)
3. Subglottic Inspiratory High-pitched

DDX

1. Supraglottic
   1. Congenital
      1. Pierre Robin sy
      2. Treacher Collins sy
      3. Macroglossia
      4. Down sy
      5. Storage dz
      6. Choanal atresia
      7. Lingual thyroid
      8. Thyroglossal cyst
      9. Adenopathy
   2. Acquired
      1. Tonsillar hypertorphy - uncommon at birth; associated with snoring or sleep related
      2. Foreign body
      3. Pharyngeal abcess - older age, muffled voice, fever, etc.
      4. Epiglottitis
2. Glottic
   1. Congenital
      1. Laryngomalacia
      2. Vocal cord paralysis - weak cry
      3. Laryngeal web
      4. Laryngocele
   2. Aquired
      1. Papillomas
      2. Foreign body
3. Subglotic
   1. Congenital
      1. Tracheomalacia
      2. Trachal stenosis
      3. Vascular ring
      4. Hemangioma cyst
   2. Aquired
      1. Croup
      2. Bacterial tracheitis
      3. Subglottic stenosis - previous endotracheal intubation; worsens with infections; often requires surgical repair
      4. Foreign body - sudden onset; asymmetric PE or CXR

Source

5/2/06 DONALDSON (adapted from Rosen)