The treatment of stridor must be tailored according to the particular underlying or predisposing condition present (see Etiology). Emergency management consists of ensuring that the airway is adequate. If it is not, appropriate resuscitative measures must be initiated. For some conditions (eg, epiglottitis and bacterial tracheitis), antibiotic therapy may be required, whereas in other scenarios, steroid therapy may be useful. [19, 20]
For certain conditions, such as the following, surgical correction is required:
Critical tracheal stenosis
Laryngeal and tracheal tumors and lesions (eg, laryngeal papillomas and hemangiomas)
Foreign body aspiration
Occasionally, tracheotomy is used to protect the airway to bypass laryngeal abnormalities and stent or bypass tracheal abnormalities. Other conditions, such as retropharyngeal and peritonsillar abscess, may have to be dealt with on an emergency basis.
Patients with moderate to severe stridor should be given nothing by mouth (nil per os [NPO]) in preparation for possible intubation, laryngoscopy, bronchoscopy, and tracheotomy.
Close clinical follow-up is important, especially in patients with congenital anomalies (eg, laryngomalacia, laryngeal webs, and vocal cord paresis), to follow disease progression.
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