Noisy Breathing (Stridor): A Medical Emergency You Must Not Ignore
Stridor is a harsh, high-pitched noise heard during breathing, most often on inhalation. It indicates critical narrowing of the upper airway and should always be treated as a medical emergency, especially in adults.
From an ENT and Head & Neck specialist’s perspective, stridor is a late and dangerous sign of airway compromise. Causes include tumours of the throat or voice box, severe infection, nerve paralysis, or trauma. Delay in assessment can be life-threatening.
What Does Stridor Sound and Feel Like?
Patients or witnesses may notice:
- Loud, harsh breathing sound
- Noise worse when breathing in
- Breathing effort or chest retraction
- Difficulty speaking full sentences
- Anxiety or panic
- Worsening when lying flat
Stridor reflects airflow obstruction, not lung disease.
Common Causes of Stridor in Adults
1. Laryngeal or Hypopharyngeal Cancer
Tumours narrow the airway and restrict airflow.
2. Vocal Cord Paralysis
Both cords fixed near midline cause airway narrowing.
3. Severe Infection
Epiglottitis or deep neck infection can cause sudden obstruction.
4. Trauma or Post-Surgical Swelling
Airway swelling compromises breathing.
5. Foreign Body or Blood Clot
Rare but immediately dangerous.
6. Advanced Head & Neck Disease
Late presentation with critical airway compromise.
🚨 When Is Stridor an Emergency?
Seek emergency care immediately if stridor is:
- Sudden or rapidly worsening
- Associated with voice change
- Accompanied by difficulty swallowing
- Associated with neck swelling
- Occurring at rest
- Associated with anxiety or exhaustion
Stridor means the airway is already dangerously narrowed.
How an ENT Specialist Manages Stridor
ENT management prioritises airway safety:
- Immediate airway assessment
- Oxygen support
- Flexible laryngoscopy (when safe)
- Imaging only after stabilisation
- Emergency airway intervention if required
- Identification and treatment of the underlying cause
Airway comes before diagnosis.
Treatment Depends on the Cause
✅ Emergency Airway Management
- Intubation or tracheostomy when needed
✅ Infection
- Intravenous antibiotics or steroids
✅ Malignancy
- Emergency airway stabilisation
- Urgent cancer referral and treatment
Early intervention saves lives.
When Should You See an ENT Specialist in Kuala Lumpur?
Immediately if:
- You or someone else has noisy breathing
- Breathing is laboured or worsening
- Speech becomes difficult
- There is known head & neck disease
Do not wait for symptoms to settle.
👨⚕️ ENT Specialist’s Perspective
Stridor is one of the most serious symptoms in ENT practice. From a head and neck oncology standpoint, it often indicates advanced disease or acute airway compromise. Prompt recognition and rapid ENT-led airway management are critical to survival.
Reviewed by Dr Ameen, ENT Specialist, Kuala Lumpur
Dr. Ameen, ENT Specialist in Kuala Lumpur 