Stridor

Stridor is an abnormal, high-pitched sound that happens when something interferes with airflow in your airway. It can occur because of narrowing or blockages in your throat, voice box or windpipe.

It’s similar to what happens when you whistle. To do that, you use your lips to make a narrow opening and blow. The narrowed opening and moving air are what make the sound. Stridor works much the same way, but it happens somewhere in your throat or windpipe.

Stridor can happen to anyone at any age, but it’s more common in children because their airways are smaller. In children, stridor can signal dangerous airway blockages or narrowing. This is why stridor that starts suddenly — especially in young children and infants — needs medical care as soon as possible.

Types of stridor

There are three types of stridor. The type you have depends on where the blockage is located:

• Inspiratory: This type happens when you breathe in. It happens because of blockages outside of your chest, like in your throat or voice box.
• Expiratory: This type happens when you breathe out. The blockages that cause it are inside your chest, like in your windpipe.
• Biphasic (laryngomalacia or laryngeal stridor): This type happens when you breathe both in and out. It happens because of narrowing at the level of your voice box (larynx) in your throat.

Symptoms of stridor

Several symptoms commonly happen alongside stridor, and some signal danger. Dangerous symptoms include:

• Any decrease in consciousness (how awake you are)
• Being unable to eat or drink
• Coughing up blood
• Difficulty breathing
• Drooling
• Pale, gray or blue tinged lips or fingertips/fingernails (cyanosis)

Some of the common, less dangerous symptoms include:

• Coughing
• Discomfort or pain when you swallow, or difficulty swallowing
• Fever
• Hoarseness
• Pain in your throat and/or neck
• Swelling in your throat and/or neck

Stridor causes

Stridor happens when something narrows or blocks part of your airway. It can be acute (new and short-term) or chronic (long-term). Some of the most common causes include:

• Upper respiratory infections, like croup (the most common cause in children, accounting for about 9 in 10 cases of stridor)
• Laryngomalacia (tissue softening that blocks your airway)
• Vocal cord dysfunction or paralysis
• Choking on a foreign object
• Injury to your airway
• Swelling in your epiglottis (cartilage that protects your voice box)

Other causes of stridor include:

• Allergic reactions, especially when they cause anaphylaxis
• A tumor, either noncancerous or malignant, like laryngeal cancer
• An abscess
• Smoke or chemical inhalation
• Neck surgery

How doctors diagnose stridor

A healthcare provider can diagnose this condition with a combination of methods. They’ll start with a physical exam, including listening to your child’s breathing with a stethoscope. They may also check to see if changing your baby’s position (like lying them on their back) affects stridor or other symptoms.

Tests providers may recommend include:

• Laryngoscopy or bronchoscopy, where a provider uses a thin, flexible tool with a camera at the tip to see down your child’s throat
• Pulse oximetry to check blood oxygen levels
• Imaging tests, like a neck or chest X-ray or CT scan
• A blood gas test to check the oxygen and carbon dioxide levels in their blood

How is stridor treated?

Stridor is generally treatable, and many of its causes are manageable or even curable. If the blockage is from a small object, using choking first aid or the Heimlich maneuver may be enough to dislodge it.

In many cases, no treatment is necessary. But if it is, a healthcare provider will first focus on stabilizing treatments as needed.

Emergency stabilizing treatments

When stridor happens because of a condition that threatens breathing ability, it’s a medical emergency. Providers will start with treatments that stabilize breathing. These include:

• Heliox: This helium-oxygen mixture is easier to breathe than regular air.
• Intubation: Inserting a tube into your airway guarantees you can keep breathing.
• Cricothyrotomy or tracheostomy: These procedures make a small opening near the base of your throat to let air directly into your windpipe. They’re an option when intubation isn’t possible.

Other treatments

You might need other treatments instead of emergency stabilizing treatments, or afterward. They can include:

• Medications to reduce swelling (inflammation), treat infections or reduce pain
• Supplemental oxygen therapy
• Surgery to remove blockages or foreign objects, or to expand your airway
• Speech therapy or similar treatments

What can I expect if I have stridor?

Stridor means that your airway is narrower than it should be. Your airway is a critical structure that allows you to breathe. Stridor that starts suddenly requires medical care as soon as possible.

If your child shows danger signs like trouble breathing, call 911 or your local emergency services number right away.

What you can expect depends on many factors. In general, quick diagnosis and treatment make a positive outcome more likely. Your healthcare provider is the best person to explain it.

Can stridor be prevented?

Many causes are preventable. Here are some things you can do:

• Supervise your child when they’re playing or eating.
• Keep small objects away from children.
• Keep small objects away from your mouth.
• Chew your food completely before swallowing it.
• Avoid secondhand smoke or other airborne irritants.
• Clean and sanitize frequently used surfaces and objects, like toys.
• Wash your hands with soap and water regularly.

Ask your healthcare provider about vaccines that can help prevent common infections that can cause stridor.

What questions should I ask my provider?

Some questions you might want to ask include:

• What’s causing my (or my child’s) stridor?
• Is it treatable?
• What can I do to help myself (or my child)?
• Are there any symptoms or changes that mean I should call your office or get emergency medical care?