PSYCHOGENIC STRIDOR - DIAGNOSIS AND MANAGEMENT

Psychogenic strider is a rare cause of apparent acute upper airway obs truction, usually occurring in young female adults, The alarming prese nce of inspiratory strider leads to suspicion of organic disease, with urgent management directed towards treatment of suspected pathology. Careful history taking may suggest the correct diagnosis and early exa mination of the larynx, preferably by fibreoptic nasendoscopic examina tion, may identify the underlying abnormality of paradoxical adduction of the vocal cords on inspiration, accounting for the strider. This c haracteristic feature allows a positive diagnosis to be made and may a void potentially harmful and inappropriate interventions. Three cases are presented, illustrating an evolution of management.