Surgery for Stridor in Children

If a narrowing of the airway is the cause of stridor, or if a child inhales a small object that gets stuck in the airway or lungs, doctors at Hassenfeld Children’s Hospital at NYU Langone may recommend endoscopic surgery. For this minimally invasive procedure, our specialists use a slender tube called an endoscope, which is inserted through a child’s mouth or nose.

Endoscopic surgery minimizes the amount of time spent in the operating room, and children often recover from surgery within days.

In some more serious cases, doctors may recommend open surgery.

Bronchoscopy

If your child develops stridor in the days or weeks after choking briefly on an object, it is possible that the object is stuck inside. The doctor may recommend an immediate bronchoscopy to remove the object.

Using general anesthesia, a surgeon inserts a bronchoscope—a long, slim instrument with a camera on the end—through your child’s nose or mouth and passes it into the lungs. The bronchoscope sends a clear image of the airway and lungs to a computer monitor. Doctors use the image to guide the position of a grasping device, which is attached to the bronchoscope. The doctor uses the device to retrieve the object, then slowly removes the bronchoscope from the airway.

After surgery, your child may have a sore throat or a scratchy voice for a day or two. Physicians may recommend children’s acetaminophen if your child seems uncomfortable. Your child returns for a follow-up visit a few weeks after the procedure to ensure that he or she has fully recovered.

Endoscopic Airway Dilation

Endoscopic airway dilation is a procedure used to enlarge the airway and make breathing easier. A doctor may recommend this procedure if the results of diagnostic tests indicate that your child has subglottic stenosis, a narrowing of the airway below the vocal cords.

Surgeons use general anesthesia to perform this procedure. Using a long, thin tube called a catheter, which has a small, deflated balloon attached to it, a surgeon inserts it into the mouth or nose and passes it into the narrowed area of the airway. After the doctor positions the balloon, he or she uses a handheld pump to gently inflate it.

As the balloon inflates, or dilates, it stretches soft tissue or scar tissue inside the airway, widening the space so more air is able to pass to and from the lungs. After a few seconds, the doctor deflates the balloon and removes the catheter.

After surgery, your child may remain in the hospital overnight for observation. He or she may feel some discomfort in the throat and airway for a few days, which can be treated with pain medication such as acetaminophen. Your child returns for a follow-up visit a few weeks after the procedure so the doctor can perform a laryngoscopy to see whether the airway has remained open.

If stenosis returns, doctors may perform a second balloon dilation procedure or may recommend surgery to remove tissue that is blocking the airway.

Open Surgery

Many possible conditions can cause stridor, and in some instances complex surgical procedures are needed to enable your child to breathe freely. If your child’s breathing problem cannot be corrected with an endoscopic technique, specialists at the Pediatric Aerodigestive Center, part of Hassenfeld Children’s Hospital, have the skills and resources to perform a more complicated procedure. They can explain the treatment options to you and determine the most effective surgical approach.

Our doctors have helped children with all types of breathing problems and have the expertise to perform surgery to remove scar tissue in the airway or address a narrowing of the airway caused by paralysis in your child’s vocal cords. If necessary, doctors can perform a tracheostomy to insert a breathing tube, creating an artificial airway that bypasses a blockage and ensures that your child can breathe.

Your child’s doctor recommends the most appropriate procedure based on the severity of symptoms and the results of diagnostic tests, and provides details such as the type of anesthesia that is used and whether your child needs to remain overnight in a hospital.