Noisy Breathing Stridor
Noisy Breathing in Infants & Children:
- Noisy breathing is a common concern among children and can stem from a variety of causes. This noise is produced when a part of the child’s airway is either blocked or narrowed. Depending on where and how severe the blockage is, different sounds can emerge, including snoring, stertor, stridor, rattling, wheezing, and grunting. A thorough examination is essential to determine the specific type of sound.
- One of the most notable sounds is called **stridor**. Stridor occurs when airflow is obstructed in the larynx or upper trachea (windpipe) and typically signals a narrowed airway.
What Causes Stridor in Children?
In infants, stridor often points to a congenital condition (present from birth), such as:
- Laryngomalacia (where the neck cartilages are softer and more flexible),
- Vocal cord paralysis (vocal cords not functioning properly), or
- Subglottic stenosis (narrowing below the vocal cords)
Other causes can include laryngeal webs, subglottic hemangiomas, or compression of the trachea by vascular rings. In toddlers and older children, stridor is commonly due to a viral infection. In rare cases, stridor may be caused by foreign body aspiration.
What Are the Red Flags Indicating a More Serious Problem?
Certain signs in children with stridor can indicate a more serious underlying issue, including:
- Chest indrawing or retractions during breathing,
- Poor weight gain,
- A weak cry,
- Cyanosis (child turning blue),
- Feeding difficulties, like choking.
How Do We Assess a Child with Noisy Breathing?
An in-depth examination is the first step in assessing a child with noisy breathing. For some children with stridor, one or more diagnostic tests may be necessary, such as:
- Flexible Bronchoscopy: This is a primary tool for assessing noisy breathing and stridor, as it allows direct visualization of the airway and windpipe to identify the source of the noise.
- Other Imaging Tests: Plain X-rays, barium swallow studies, and CT scans of the chest may also be conducted for a more comprehensive evaluation.
