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Stridor| definition, causes, types and clinical picture

Definition: Difficult noisy respiration indicating partial airway obstruction in larynx &/or  trachea.
Types
a. Inspiratory laryngeal: at or above glottis.
b. Biphasic: subglottic or tracheal.
c. Expiratory: bronchial.
stridor

Causes of stridor:

I. Congenital:
  • Congenital web 
  • Laryngo malacia.
  • Subglottic stenosis
  • Subglottic haemangioma.
  • Congenital cyst 
  • Congenital bilateral cord palsy
II. Traumatic:
  • Mechanical: Sharp, blunt, surgical, intubation, F.B.
  • Physical: Radiotherapy, thermal.
  • Chemical: Corrosives.
III. Inflammatory:
  • Acute non-specific laryngitis, in children
  • Acute epiglottitis.
  • Acute laryngotracheobronchitis in children.
  • Laryngeal diphtheria.
  • Chronic specific laryngitis (granulomas)
IV. Neoplastic
  • Benign: Multiple papillomatosis, subglottic chondroma.
  • Malignant: Carcinoma.
V. Miscellaneous
  • Neurological: Bilateral abductor paralysis. Laryngeal spasm e.g. tetany
  • Tumor like conditions: Laryngeal cysts, laryngocele, amyloidosis.
  • Laryngeal oedema.
VI. Tracheal causes
  • Retrosternal goiter, mediastinal LN, thymus hyperplasia,& deep neck infection

Clinical picture of stridor:

  • Dyspnea & tachypnea.
  • Irritability, restlessness, fatigue, sweating.
  • Working alae nasi.
  • Suprasternal, supraclavicular & intercostal retraction.
  • Working accessory muscles of respiration.
  • Tachycardia.
  • Congested neck veins.
  • Late: Cyanosis, and bradycardia. Finally: coma & cardiac arrest.

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