Congenital Stridor Treatment & Management

Updated: Jan 21, 2015
  • Author: Timothy D Murphy, MD; Chief Editor: Michael R Bye, MD  more...
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Treatment

Medical Care

Medical care is primarily supportive because many causes of congenital stridor resolve spontaneously over time. For those that do not, such as vascular rings, surgical treatment is usually definitive. However, in some patients, tracheomalacia persists for some time after such a repair. In severe cases of congenital stridor, nonsurgical therapy may have a role prior to definitive surgical correction. [5]

  • Supplemental oxygen can be used to treat hypoxemia.
  • Noninvasive positive pressure mechanical ventilation can maintain a patent airway in cases of airway collapse, such as tracheomalacia.
  • If an airway cannot be maintained by noninvasive positive pressure mechanical ventilation, intubation with mechanical ventilation may be indicated.
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Surgical Care

Surgical management depends on the specific lesion that causes stridor.

  • In general, indications for surgical correction include the following:
    • Inability to maintain a patent airway
    • Feeding difficulties or failure to thrive [2]
    • Inability to maintain adequate oxygenation
  • Some of the surgical procedures used to treat congenital stridor include the following:
    • Epiglottoplasty for laryngomalacia [9]
    • Tracheostomy for severe subglottic stenosis or tracheomalacia
    • Division of a vascular ring
    • Tracheoplasty for complete tracheal rings
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