• Ghada Alsowailmi, Jaber Alshammari, Abdullah Saud Arafat, Amal Alotaibi, Afnan Alsahli, Sara Ibrahim Alshahwan, Aamir Omair, and Maryam Alsafi.
• From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2021 Jul 1; 41 (4): 216-221.

BackgroundSuccessful evaluation of a patient with stridor requires a thorough history and physical examination followed by a flexible fiberoptic laryngoscopy (FFL), which provides visualization of the upper airway.ObjectivesEstimate the prevalence of causes of stridor in children who underwent FFL and compare different age groups. Find any significant associations between symptoms and laryngoscopic findings. Identify patients who needed further evaluation using direct laryngobronchoscopy (DLB).DesignRetrospective, cross-sectional.SettingTertiary care center in Riyadh.Patients And MethodsWe included all pediatric patients aged 1 month to 14 years who underwent fiberoptic laryngoscopy for stridor evaluation from January 2015 to January 2018 (37 months). Patients older than the age of 14 years, and patients with a workable diagnosis with adenotonsillar hypertrophy, choanal atresia, or laryngotracheo-bronchitis (croup) were excluded.Main Outcome MeasuresFindings of FFL.Sample Size217 pediatric patients.ResultsThe median (interquartile range) age of the patients was 5 (8) months. Laryngomalacia was the most common diagnosis (n=149, 69%) followed by laryngopharyngeal reflux (n=42, 19%). Subglottic stenosis was the most common finding in patients who underwent DLB for further evaluation (n=19, 49%). Laryngomalacia was more frequent in children ≤12 months of age (83% vs 43% in children >12 months, P<.001). Vocal cord paralysis was more common in children >12 months of age (27% vs 9%, P<.001). FFL was effective in finding the diagnosis in 178 (82%) patients; only 39 (18%) patients needed further assessment using DLB.ConclusionFFL is an effective and important tool for evaluating patients with stridor.LimitationsRetrospective design and single-centered.Conflicts Of InterestNone.

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