A Rare Cause of Extremely Loud Expiratory Stridor in a 11-Year-Old Patient

Stridor can be a very alarming symptom in children, as it is typically caused by turbulent airflow through a partially obstructed airway, due to an organic cause. An abnormal respiratory sound can induce the suspicion of a life-threatening clinical condition and requires an immediate diagnostic assessment. The aim of this article is to describe a very peculiar case of loud expiratory stridor, with an abrupt onset and no other associated symptoms, occurring in an 11-year-old girl. The stridor sounds ceased only during sleep at night. Videolaryngoscopy demonstrated that the anatomy and patency of the larynx were normal, and expiratory noise was generated by vibration of the supraglottic structures. Voice therapy led to remission of stridor within 3 weeks. To the best of our knowledge, this is the first reported case of expiratory stridor with such striking volume and characteristics related to psychological causes. This peculiar clinical condition needs to be taken into consideration in the differential diagnosis of pediatric stridor to avoid unnecessary and invasive procedures and treatments.Laryngoscope, 2020