Introduction:
Stridor is a sign of upper airway obstruction. It may be inspiratory,
expiratory or biphasic depending on the site of obstruction. Inspiratory
stridor suggests airway obstruction above the glottis while lower
tracheal lesion presents with expiratory stridor. A biphasic stridor
suggests a glottic or subglottic lesion. Stridor may be caused by
abnormalities in nose, pharynx, larynx or trachea. Laryngomalacia stays
the commonest cause of stridor amongst infants (1). Other causes include
various congenital and acquired conditions like subglottic stenosis,
tracheal stenosis, gastro-esophageal reflux disease (GERD), foreign body
aspiration, vocal cord paralysis, external tracheal obstruction,
laryngeal web, hemangioma and cysts (2,3). It is essential to determine
the appropriate etiology of stridor in order to start prompt therapy.
Flexible bronchoscopy (FB) plays an important role as a diagnostic
modality to determine the etiology of stridor. It helps in diagnosing
both static anatomic or dynamic obstruction in upper and lower airway of
children. FB is not a routine investigation carried out in all children
with stridor; however, if done in cases with chronic and severe cases,
can provide a prompt diagnosis. During evaluation of upper airway to
find for the cause of stridor, it is advisable to evaluate the lower
airway too as almost 68% of the patients with upper airway anomalies
have associated lower airway anomalies (4).
This study aims to describe the clinical characteristics, FB findings
and its clinical correlation in children having clinical symptoms of
stridor.