Stridor

What is stridor?

Stridor is an abnormal high-pitched sound you make when you inhale or exhale. This sound happens when you have a blockage in your throat (pharynx), voice box (larynx) or windpipe (trachea).

What are the types of stridor?

There are three types of stridor characterized by where there is a blockage in your airway:

• Inspiratory: A blockage in your throat or voice box (extrathoracic region) that causes symptoms when you breathe in.
• Expiratory: A blockage above your lungs in your windpipe (intrathoracic region) that causes symptoms when you breathe out.
• Biphasic (laryngomalacia or laryngeal stridor): Narrowing of the cartilage below the vocal cords that causes symptoms when you breathe in and out.

How common is stridor?

Stridor can affect anyone at any age, but it’s more common among children since their airways are narrower than adults, which makes them more at risk of getting airway blockages. Sometimes stridor can be present at birth (congenital).

The exact rate of occurrence varies by the cause. In children, stridor caused by an upper airway infection (viral croup) is the most common, and affects an estimated 5 to 6 toddlers out of 100, between 6 months to 3 years of age. Stridor caused by objects stuck in the larynx or trachea (foreign body aspiration) accounts for an estimated 17,000 emergency room visits per year in the United States.

How does stridor affect my body?

Stridor is the result of a blockage in your airway. This can make breathing difficult since air isn’t able to smoothly pass in and out of your airways like it normally would. Stridor can cause other life-threatening symptoms if left untreated because your body relies on oxygen intake and carbon dioxide outtake to survive and keep your organs functioning.

What’s the main sign of stridor?

The main sign of stridor is a high-pitched whistle that can sound like a squeak when you breathe in or out.

Depending on the cause, you might experience additional symptoms that could include:

• Coughing.
• Drooling.
• Hoarseness.
• Pain in your throat and/or neck.
• Fever.
• Swelling in your throat and/or neck.
• Discomfort when you swallow.

Severe symptoms that need immediate medical attention include:

• Difficulty breathing.
• Your lips, fingertips or skin turn blue to purple color.
• You can’t eat or drink.
• You cough up blood.

If you have severe symptoms, visit the emergency room immediately or call 911.

What causes stridor?

There are several causes of stridor. The most common causes of stridor include:

• An upper airway infection (viral croup). This is the most common cause in children and accounts for approximately 90% of causes of stridor.
• Airway blockage by a foreign object (foreign body aspiration).
• Injury to your airway.
• Swelling (tonsillitis epiglottitis).

Other causes of stridor include:

• Allergic reaction.
• A tumor (laryngeal cancer).
• An abscess.
• Vocal cord dysfunction or paralysis.
• Smoke or chemical inhalation.
• Neck surgery.

What happens to my body if I have stridor?

Your respiratory system airways consist of your throat (pharynx), voice box (larynx) or windpipe (trachea and bronchi). Your mouth and nose help your airways bring oxygen into your lungs when you inhale and release carbon dioxide when you exhale. Your body needs oxygen to survive.

Like a trumpet, your airways produce sound when air travels through them by creating vibrations. When you press the keys on a trumpet, the sound that the instrument makes changes. This happens because the pressed key blocks the movement of air and changes the vibration. If you have a blockage in your airways, the sound that you produce when you inhale and exhale will change in the same way that a pressed key changes the sound of a trumpet.

How is stridor diagnosed?

Your provider will diagnose the cause of your stridor after gathering more information about your medical history and your symptoms. They will perform a physical exam and will recommend tests to verify your diagnosis, which could include:

• An imaging test like a neck or chest X-ray.
• A blood gas test to check the oxygen and carbon dioxide levels in your blood.
• A pulse oximeter to check your blood oxygen levels.
• Laryngoscopy or bronchoscopy to look inside your airways and lungs with a small tube (scope) with a light on it.

How is stridor treated?

Treatment for stridor focuses on opening your airways and/or removing the blockage in your airways. Treatment varies based on what caused your stridor but could include:

• Surgery to remove the blockage or foreign object or expand your airways.
• Medicine to reduce swelling (inflammation), treat an infection or reduce pain.
• Performing the Heimlich maneuver to dislodge airway blockage if you choked on an object.
• Receiving supplemental oxygen through a mask or a nasal tube.
• Inserting a tube into your mouth, nose or surgically inserting a tube into your trachea to allow air to flow past the blockage until your provider can remove it.

After treatment, your provider will monitor your symptoms to make sure it was successful and that you’re safely recovering.

How soon after treatment will I feel better?

Your recovery time depends on the cause of your stridor. It depends on what type of treatment your provider used to remove or treat the blockage in your airway. Medicine could make you feel better within two to three days. Surgery has a longer healing time and could take several weeks before you feel back to normal. Regardless of what type of treatment you need, you will feel immediate relief after your provider removes the blockage.

How can I reduce my risk of stridor?

You can’t prevent all cases of stridor because there are several different causes, but you can take steps to reduce your risk of getting stridor by:

• Supervise your child when they’re playing or eating.
• Cut your food into small, bite-sized pieces to prevent choking.
• Chew your food completely before swallowing it.
• Keep small objects away from children or away from your mouth.
• Avoid areas where there is smoke.
• Clean and sanitize frequently used surfaces and objects like toys.
• Wash your hands with soap and water regularly.

What can I expect if I have stridor?

Quick treatment to remove the airway blockage leads to a positive prognosis. Your provider will diagnose the cause of your stridor and treat you immediately to prevent any complications.

Stridor can be life-threatening if you don’t receive treatment right away, which can cause respiratory failure. Respiratory failure happens when your blood doesn’t have enough oxygen to keep your body functioning.

When should I see my healthcare provider?

Visit your healthcare provider if you have stridor. Stridor is a sign that something life-threatening is occurring to you. Stridor will lead to life-threatening complications if left untreated, so don’t wait to see your provider.

When should I go to ER?

Visit the emergency room or call 911 immediately if you have new onset of stridor or any trouble breathing.

What questions should I ask my doctor?

• What can I eat or drink after surgery to remove a blockage in my airway?
• Are there side effects to the medicine you recommend?
• Do I need to schedule a follow-up appointment to check my symptoms?
• How can I stop my child from putting small objects near their mouth?

Is stridor the same as wheezing?

While you might hear stridor referred to as wheezing, there are differences between the two symptoms. Stridor and wheezing, both sound like a high-pitched whistle.

Stridor occurs when you have a blockage in your central (larger) airway (extrathoracic region). Wheezing occurs when your airways tighten (intrathoracic airways)

Wheezing is common among people diagnosed with allergies or asthma. Stridor happens among children or adults who have a blockage in their airway, most often by a foreign object or infection.

What is the difference between stridor and stertor?

Stertor is noisy breathing that happens above your voice box (above your larynx). It is typically low-pitched.

Stridor is noisy breathing in your airway that includes your voice box (larynx) and below, which includes your windpipe (trachea).

A note from Cleveland Clinic

Stridor is your body telling you, via an unusual noise when you inhale (or exhale), that something abnormal is happening to your airway. The noise that you make is a sign that something is in your airway that needs removing or treated. Don’t wait to contact your provider because your body needs oxygen to survive. Treatment is very successful to stop your noisy breathing and make you feel better.