Have you ever felt a high-pitched, whistling sound coming from your throat or neck, sometimes when you breathe in or out? Or have you heard your little one make a whistling sound? This is what we call stridor in medical terms. It can be a little scary to hear, but don't worry. Let's understand everything about this condition called stridor.
What exactly is Stridor?
Simply put, stridor is a sign that there is an obstruction or blockage somewhere in your throat, or pharynx, or larynx, or trachea. It's like a water pipe that makes a noise when the water flows. When this airway is blocked, an abnormal, high-pitched sound is created as the air moves back and forth.
Imagine, if we just take a straw and press one end of it a little and blow into it, it will make a sound. That's what stridor sounds like.
Are there types of stridor?
Yes, there are three main types of stridor. These are classified based on where in the airway the obstruction occurs.
1. Inspiratory stridor: This occurs when there is an obstruction in your pharynx or larynx (i.e., the extrathoracic region). The sound is heard when you inhale.
2. Expiratory stridor: Here the obstruction is just above your lungs, in the trachea (intrathoracic region). So the sound is made when you breathe out.
3. Biphasic stridor: A good example of this is a condition called Laryngomalacia. This is when the cartilage below the vocal cords is weak, causing the airway to narrow and make a sound both when breathing in and out . This can be present in some babies from birth.
Who is more likely to develop stridor?
Stridor can affect anyone of any age. However, it is more common in young children than in adults . This is because the airways of young children are not as wide as those of adults, they are much narrower. Therefore, even a small object or a small swelling can easily block them. Sometimes, stridor can be present at birth (congenital).
How common it is varies depending on the cause. For example, stridor is most commonly caused by viral croup, an upper respiratory infection that affects young children. It is estimated that this condition affects about 5 to 6 out of 100 children under the age of 3. Stridor can also be caused by foreign body aspiration, which occurs when something gets stuck in the throat or airway. In the United States alone, about 17,000 such cases are reported to emergency departments each year.
How does stridor affect my body?
Stridor is a condition caused by a blockage in the airway. This means that air cannot enter or leave the lungs normally. This can make it difficult to breathe . Every organ in our body needs oxygen to function properly, and carbon dioxide needs to be expelled. So, if this condition of Stridor is not treated quickly, the body may not get the required amount of oxygen, which can lead to other complications that can be life-threatening .
What is the main sign of stridor?
The main sign of stridor is a high-pitched whistling sound that is heard when breathing in or out . It can sometimes sound like a low groan.
Depending on the cause, you may experience other symptoms:
- Cough
- Spitting up (especially for little ones)
- Hoarseness, change in voice
- Sore throat and/or neck pain
- Fever
- Swelling in the throat and/or neck
- Difficulty and pain when swallowing
Severe symptoms that require immediate medical attention:
If you have these symptoms, you should go to a hospital immediately , or call 1990:
- Severe difficulty breathing
- Lips, fingertips, or skin turning blue or purple (this means the body is not getting enough oxygen)
- Not being able to eat or drink anything
- Coughing up blood
If you have these severe symptoms, never stay home . It is important to seek medical advice as soon as possible.
What are the causes of stridor?
There are several causes of stridor. The most common causes are:
- An upper respiratory tract infection (e.g., viral croup) : This is the most common cause of stridor in young children, accounting for about 90% of all cases of stridor.
- Foreign body aspiration : Small children can choke on objects such as toys and food.
- Any accident or injury to the respiratory tract.
- Swelling (e.g. tonsillitis, epiglottitis). Epiglottitis is a very serious condition.
There may be other reasons:
- An allergic reaction (severe allergy)
- A lump (e.g., laryngeal cancer)
- Abscess
- Vocal cord dysfunction or paralysis
- Inhalation of smoke or chemicals
- Having had neck surgery
What happens to my body when I have stridor?
The respiratory tract of our respiratory system consists of the throat (Pharynx), larynx (Larynx), trachea (Trachea), and bronchi (Bronchi). The mouth and nose help to carry oxygen to the lungs through these airways, and to expel carbon dioxide. Oxygen is essential for our body to survive.
Think of a musical instrument like a trumpet. It makes a sound from the vibrations of the air as it passes through it. When we press the keys of the trumpet, the sound it makes changes. That's because the key we press blocks the air passage, changing the vibrations. In the same way, if there is a blockage in your airway, the sound you make when you inhale and exhale will change, just like when you press a key on a trumpet, the sound changes.
How do doctors diagnose stridor?
Your doctor will determine the exact cause of your stridor by taking your symptoms, medical history, and examining you. Then, they may do some other tests to confirm the diagnosis. Some of these include:
- Imaging tests: An X-ray of the neck or chest.
- Blood gas test: This checks the levels of oxygen and carbon dioxide in your blood.
- Pulse oximeter: This small device is attached to the finger and measures the oxygen level in the blood.
- Laryngoscopy or Bronchoscopy: This involves inserting a small, camera-equipped tube (endoscope) through your mouth or nose to look inside your airways and lungs. This can help you see exactly where the blockage is and what it looks like.
How is Stridor treated?
The main focus of treatment for stridor is to open the airway and/or relieve the obstruction . The treatment depends on the cause of your stridor. However, some of the treatments may include:
- Surgery: To remove the blockage or stuck foreign object, or to widen the airway.
- Medication: Reduce swelling (inflammation), treat infection if present, and reduce pain.
- Heimlich maneuver: This method is used to remove something that is stuck in the throat.
- Supplemental oxygen: Oxygen is given either through a mask or a small tube placed in the nose.
- Insertion of a tube into the airway: A tube is surgically inserted into the windpipe (trachea) through the mouth, nose, or throat, creating a passageway for air to pass through until the doctor removes the blockage.
After treatment, your doctor will continue to monitor your symptoms to see if the treatment is successful and if your recovery is safe.
How quickly will I recover after treatment?
The time it takes for you to recover depends on what caused your stridor and what treatment your doctor used to relieve the airway obstruction. With medication, you should feel better in two to three days. With surgery, it can take a little longer, and it can take a few weeks for you to get back to normal. However, no matter what treatment you choose, you should feel immediate relief once the obstruction is relieved .
How can you reduce the risk of stridor?
There are many causes of stridor, so it's impossible to avoid them all. However, you can do the following to reduce your risk:
- Keep a close eye on your toddler while they are playing and eating. Keep small objects out of their way that they might put in their mouths.
- When eating, cut food into small pieces, chew it well, and swallow it. That way, you'll be less likely to choke.
- Do not leave small toys or coins where small children can get hold of them.
- Reduce your exposure to smoky places.
- Keep frequently used toys and items clean and disinfected.
- Wash your hands often with soap.
What should I expect if I have stridor?
The sooner you seek treatment to clear the airway obstruction, the better the outcome. Your doctor can find the cause of your stridor and treat you quickly before any complications arise.
But remember, if stridor is not treated quickly, it can be life-threatening . It can lead to conditions like respiratory failure. Respiratory failure is when your blood doesn't get enough oxygen to keep your body's organs functioning.
When should I see my doctor?
If you have symptoms of stridor, be sure to see a doctor . Stridor is a sign that something is happening in your body that could be life-threatening. Don't put off seeing a doctor, as it can lead to dangerous complications if left untreated.
When should I go to the Emergency Treatment Unit (ETU) ?
If you have new onset stridor, or if you have any difficulty breathing, go to the emergency room immediately, or call 911 .
What questions should I ask my doctor?
- If I have surgery to remove a blockage in my airway, what can I eat and drink afterward?
- Are there any side effects to the medications you recommend?
- Do I need to come back for a follow-up appointment to check my symptoms?
- How can I stop my toddler from putting small things in his mouth?
Are stridor and wheezing the same thing?
Although some people use the term "wheezing" interchangeably with "stridor," there are differences between the two symptoms. Both "stridor" and "wheezing" sound like a high-pitched whistle.
- Stridor occurs when there is an obstruction in your central (large) airway (throat, larynx, trachea - more in the `extrathoracic region`).
- Wheezing occurs when the small airways inside your lungs (intrathoracic airways) become blocked or narrowed. This is common in people with asthma and allergies.
Stridor is most commonly seen in young children, adults who have something blocked in their airways, or those who have an infection.
What is the difference between Stridor and Stertor?
- Stertor is also an abnormal sound that you make when you breathe. But it occurs when there is a blockage above your larynx, which is the upper part of your nose and throat. This sound is usually heard in a slightly hoarse, low-pitched tone. It's like snoring.
- Stridor is a high-pitched sound caused by obstruction of the larynx and the trachea below it.
Simply put, stridor is an abnormal sound that you make when you inhale (or exhale), a signal from your body that there is something wrong with your airway and that needs to be addressed or treated. If you experience this sound, don't ignore it. Because oxygen is essential for our bodies to survive. There are treatments for this, and with those treatments, you can eliminate this abnormal breathing sound and get well.
## Important things to remember (Take-Home Message)
- Stridor is a high-pitched, whistling sound heard when breathing in or out. It is a sign of airway obstruction.
- This is common in young children, because their airways are narrow.
- Infections like croup and something stuck in the throat can be the main causes.
- If you have symptoms like severe difficulty breathing and blue skin, it's an emergency! Go to the hospital immediately.
- Stridor can be fully cured by finding and treating the cause.
- Never ignore a symptom like this. It is wise to seek medical advice.
It is very important for you and your family to be aware of these symptoms. Stay healthy!
` Stridor, Difficulty breathing, Respiratory diseases, Throat congestion, Croup, Child health, Emergency care
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