Stridor is a high-pitched, wheezing sound caused by
disrupted airflow. Airflow is usually disrupted by a blockage in the larynx
(voice box) or trachea (windpipe). It’s most noticeable when breathing in, though
it can sometimes be heard when breathing out. Stridor affects children more
often than adults.
infants, a condition called laryngomalacia is
usually the cause of stridor. It may be quieter when your child is lying on their
stomach, and louder when lying on their back. Larynogomalacia is most
noticeable when your child is about 6 months old. It may start as soon as a few
days after birth. As your child ages, their airway stiffens, and the stridor
often goes away. Stridor may go away by the time your child is 2 years old. For
some children, it may continue for another year or two.
may also be called “abnormal breathing sounds,” “musical breathing,” or
“extrathoracic airway obstruction.”
Who Is at Risk for Stridor?
Children have narrower, softer airways than adults
do. They’re much more likely to develop stridor. The condition should be
treated immediately to prevent further blockage. If the airway is completely
blocked, your child won’t be able to breathe.
What Causes Stridor?
collected by the Cincinnati Children’s Hospital suggest
that laryngomalacia is responsible for 50 to 75 percent of stridor cases in
infants. Laryngomalacia is caused by soft structures and tissues that obstruct
the airway. It often goes away as your child ages and their airways harden.
Symptoms of laryngomalacia include:
low-pitched or squeaky breathing sound that may be more noticeable when your
child is lying on their back, feeding, or crying
- sometimes present along with gastric
reflux (stomach acid coming up into the throat)
Stridor may also be caused by:
- an object blocking the airway
- swelling in your child’s throat or
- trauma to the airway, such as a
fracture in the neck or an object stuck in the nose or throat
- neck surgery
- inhaling smoke
- swallowing a harmful substance that
causes damage to the airway
- croup (viral
- vocal cord paralysis
- bronchitis (inflammation of the airways leading to
- tonsillitis (inflammation of the lymph nodes at the
back of the mouth and top of the throat by viruses or bacteria)
- epiglottitis (inflammation the tissue covering the
windpipe caused by the H. influenza bacterium)
- tumors (less common) or abscesses (a collection of pus or fluid)
Other conditions that may cause stridor include:
- Subglottic stenosis, in which the
voice box is too narrow. Many children outgrow this condition, though surgery may
be necessary in severe cases.
- Subglottic hemangioma, in which a
mass of blood vessels forms and obstructs the airway. This condition may
require surgery and is very rare.
- Vascular rings, in which the windpipe
is compressed by an outer artery or vein. Surgery may be required to release
How Is Stridor Diagnosed?
Your doctor will try to find the cause of your
child’s stridor. They’ll give your child a physical examination and ask
questions about your child’s medical history.
Your doctor may ask questions about:
- the sound of the abnormal breathing
- when you first noticed the condition
- other symptoms, such as a blue color in your child’s face or skin
- if your child has been ill recently
- if your child could have put a foreign object into his or her mouth
- if your child is struggling to breathe
Your doctor may also order tests, such as:
- X-rays to check your child’s chest and neck for signs of blockage
- CT scan of the chest
- a bronchoscopy to provide a clearer view of the airway
- a laryngoscopy to examine the voice box specifically
- a pulse oximetry and arterial blood gases test to measure the
amount of oxygen in the blood
- If your doctor suspects an infection,
they’ll order a sputum culture. This test checks material your child coughs up
from their lungs for viruses and bacteria. It helps your doctor see if an infection,
such as croup, is present.
How Is Stridor Treated?
Don’t wait to see if stridor goes away without
medical treatment. Visit your doctor and follow their advice. Treatment options
vary depending on the age and health of your child, as well as the cause and
severity of the stridor.
Your doctor may:
- refer you to an ear, nose, and throat
- provide oral or injected medication
to decrease swelling in the airway
- recommend hospitalization and/or
surgery in severe cases
- require additional monitoring
Contact your doctor immediately if you see:
- a blue color in your child’s lips,
face, or body
- signs of difficulty breathing, such
as the chest collapsing inward
- weight loss
- trouble eating or feeding