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.