ABSTRACT
Stridor is a high pitched respiratory sound usually inspiratory, but may be expiratory or biphasic produced by turbulent airflow due to partial airway obstruction at the level of the pharynx, larynx and/or trachea. Stridor can be classified into two types: acute stridor and persistent or chronic stridor. Evaluation of child with persistent stridor includes radiological assessment mainly plain X-ray and fluoroscopy. Direct visualization of the airway is often necessary to confirm the diagnosis and is essential in children with persistent stridor. The aim of this study was to determine the role of flexible fiberoptic and rigid bronchoscopy in comparison with fluoroscopy in diagnosing the site of partial upper airway obstruction in infants and children with persistent stridor. The study was conducted on 35 infants and children presented by persistent stridor. Fluroscopy and bronchoscopy [Flexible or rigid] were done for all the cases. The results obtained from fluoroscopy were compared to those obtained from bronchoscopy. The most common type of stridor was inspiratory in 80% of cases followed by biphasic stridor [11.4%], and lastly, the expiratory stridor [8.6%]. The most common cause of stridor in the studied group was Laryngomalacia in 17 cases [48.6%]. Flexible and rigid endoscopy were able to diagnose the site as well as the pathology in 35/35 of studied cases [100%]. Fluoroscopy delineated the site of obstruction in 4/35 cases [11.4%], two cases had external compression by vascular ring, one case of subglottic stenosis and one case with congenital tracheal stenosis. This study demonstrated the usefulness and safety of bronchoscope either flexible or rigid, in infants and children with persistent stridor. It usually provides rapid and precise diagnosis without significant complications. Diagnostic radiological modality as fluoroscopy needs more improvement. It may serve as a cost-effective screening tool in the evaluation of stridor in children, especially for lesions of the lower airway