Paediatric, Stridor (Persistent)
Pathway Home
Population Covered By The Guidance
This pathway provides guidance on imaging young children with persistent unexplained stridor.
Date reviewed: July 2014
Date of next review: July 2023
Published: July 2014
Quick User Guide
Move the mouse cursor over the PINK text boxes inside the flow chart to bring up a pop up box with salient points.
Clicking on the PINK text box will bring up the full text.
The relative radiation level of each imaging investigation is displayed in the pop up box.
SYMBOL | RRL | EFFECTIVE DOSE RANGE | |
![]() |
None | 0 | |
![]() |
Minimal | < 1 millisieverts | |
![]() |
Low | 1-5 mSv | |
![]() |
Medium | 5-10 mSv | |
![]() |
High | >10 mSv |
Images
Teaching Points
Teaching Points
- Chronic or persistent stridor lasts for more than 3 weeks or recurs on more that 3 occasions
- Initial investigation of persistent stridor is an antero-posterior and lateral views of the chest and neck
- Further investigations are dictated by the most likely diagnosis, based on the age of the child, the onset of symptoms and findings on clinical history and examination
References
References
References are graded from Level I to V according to the Oxford Centre for Evidence-Based Medicine, Levels of Evidence. Download the document
- Landau LI. Investigation and treatment of chronic stridor in infancy. Monaldi Arch Chest Dis. 1999;54:18-21. (Review article)
- Goodman TR, McHugh K. The role of radiology in the evaluation of stridor. Arch Dis Child 1999;81:456-9. (Review article).
- Jasin ME, Osguthorpe JD. The radiographic evaluation of infants with stridor. Otolaryngol Head Neck Surg. 1982;90:736-9. (Review article)
- O'Halloren MT, Everts EC. Evaluating the patient with stridor. Ann Allergy. 1991;67:301-5. (Review article)
- Zalzal GH. Stridor and airway compromise. Pediatr Clin North Am. 1989;36:1389-1402. (Review article)
- Friedman EM, Vastola AP, McGill TJ, Healy GB. Chronic pediatric stridor: etiology and outcome. Laryngoscope. 1990;100:277-80. (Level III evidence)
- Silva AB , Muntz HR, Clary R. Utility of conventional radiography in the diagnosis and management of pediatric airway foreign bodies. Ann Otol Rhinol Laryngol. 1998;107:834-8. (Level IV evidence)
- Svedstrom E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol. 1989;19:520-2. (Level III evidence)
- Tostevin PM, de Bruyn R, Hosni A, Evans JNG. The value of radiological investigations in the pre-endoscopic assessment of children with stridor. J Laryngol Otol. 1995;109:844-8. (Level III evidence). View the reference
- Rosbe KW, Kenna MA, Auerbach AD. Extraesophageal reflux in pediatric patients with upper respiratory symptoms. Arch Otolaryngol Head Neck Surg. 2003;129:1213-20. (Level III evidence)
- Yellon RF, Goldberg H. Update on gastroesophageal reflux disease in pediatric airway disorders. Am J Med. 2001;111:78S-84S. (Review article)
- Contencin P, Gumpert LC, de Gaudemar I, Chaussain M, Dupont C. Non-endoscopic techniques for evaluation of the pediatric airway. Int J Pediatric Otorhinolaryngol. 1997;41:347-52. (Review article)
- Beekman RP, Beek FJ, Hazekamp MG, Meijboom EJ. The value of MRI in diagnosing vascular abnormalities causing stridor. Eur J Pediatr. 1997;156:516-20. (Level III evidence). View the reference
- Kussman BD, Geva R, McGowan FX. Cardiovascular causes of airway compression. Pediatr Anesth. 2004;14:60-74. (Review article)
- Pacharn P, Poe SA, Donnelly LF. Low-tube-current multidetector CT for children with suspected extrinsic airway compression. AJR Am J Roentgenol. 2002;179:1523-7. (Level III evidence). View the reference
- Rudman DT, Elmaraghy CA, Shiels WE, Wiet GJ. The role of airway fluoroscopy in the evaluation of stridor in children. Arch Otolaryngol Head Neck Surg. 2003;129:305-9. (Level III evidence)
- John SD, Swischuk LE. Stridor and upper airway obstruction in infants and children. Radiographics. 1992;12:625-43. (Review article)
Information for Consumers
Information for Consumers
Information from this website |
Information from the Royal Australian and New Zealand College of Radiologists’ website |
Consent to Procedure or Treatment Radiation Risks of X-rays and Scans Magnetic Resonance Imaging (MRI) |
Magnetic Resonance Imaging (MRI) Radiation Risk of Medical Imaging for Adults and Children Children's (Paediatric) X-ray Examination |
File Formats
Some documents for download on this website are in a Portable Document Format (PDF). To read these files you might need to download Adobe Acrobat Reader.