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with developmental delays. There may be a history of choking on food or a small
object. Physical examination varies, depending on the location of the foreign
body (see Chapter 32 Foreign Body: Ingestion and Aspiration ).
Both ingestion and inhalation of caustic or thermally damaging substances may
result in injury to the airway or hypopharynx (see Chapter 104 Burns ).
Symptoms of airway compromise may be delayed for as long as 6 hours. Blind
finger sweeps have also been reported rarely to result in stridor. Other causes to
consider include spasmodic croup, anaphylaxis, angioneurotic edema, and
trauma.

Chronic Stridor
The differential diagnosis of chronic stridor varies with patient age. Stridor noted
shortly after birth is most likely caused by an anatomical defect. This type of
stridor tends to slowly worsen and is severe when the infant is crying or agitated.
Laryngomalacia is the most common cause of congenital stridor accounting for
up to 75% of chronic stridor in children younger than 1 year. Stridor associated
with laryngomalacia is positional and may be relieved by placing the child in the
prone position. It frequently disappears when the child cries. Other congenital
causes of stridor include laryngeal webs, laryngeal diverticula, vocal cord
paralysis, subglottic stenosis, tracheomalacia, and vascular anomalies such as a
double aortic arch or a vascular sling. Stridor in infants has also been reported to
be associated with gastroesophageal reflux, possibly related to associated
laryngomalacia, or acutely secondary to partial laryngospasm.