Pediatric Airway Disorders

Stridor (Noisy Breathing)

Stridor is noisy breathing that occurs due to obstructed air flow through a narrowed airway. Stridor is not in and of itself a diagnosis but is a symptom or sign that points to a specific airway disorder.

What causes stridor?

Stridor can be caused by any process that causes airway narrowing. In the infant, stridor usually indicates a congenital disorder (problem that your child is born with), including laryngomalacia, vocal cord paralysis or subglottic stenosis. In the toddler or older child, stridor may occur as a result of an infection such as croup or papillomatosis. In rare circumstances, stridor can occur secondary to trauma or foreign body aspiration.

What are the types of stridor?

The timing and the sound of your child's noisy breathing provides clues to the type of airway disorder:

How is stridor evaluated?

The evaluation of stridor begins with a history and physical examination. Important history will include questions regarding the onset, duration and progression of stridor as well as associated feeding or voice disturbances.

The physical examination begins with an assessment for signs of respiratory distress (nasal flaring, retractions, color change, etc.).

Once the child is determined to be stable, the physician will evaluate specific features of the stridor (inspiratory, expiratory, biphasic) and voice.

The airway doctor may recommend one or more of these diagnostic tests:

How is stridor treated?

Stridor treatment depends upon many factors, such as the cause of the noisy breathing and the severity of the condition. Your child's treatment will be tailored to meet her unique needs. Multidisciplinary care is often provided by a team of airway surgeons, speech pathologists, gastroenterologists, pulmonary physicians, social workers and nurses.

Treatment options may include:


Berg E., Naseri I. Sobol S. The role of airway fluoroscopy in the evaluation of children with stridor. Arch Otolaryngol Head Neck Surg. 2003 Mar;129(3):305-9.

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