This occurs in the larynx and trachea in croup, the bronchi in asthma. Again, we see considerable overlap clinically, hence the child with a croupy cough and stridor who improves with Ventolin and Atrovent, due to a bronchial component. Sometimes wheeze, being the more musical of the two sounds, is less easily heard than the stridor. If we consider croup as an expression, in a good number of cases, of eosinophils at work, it makes sense to use corticosteroids in treatment. Recently, a number of studies have looked at the best way to go about this.
Oral steroid seems to work very well, at least as well as topical.
The accompanying flow chart gives you a skeleton to work with. Neither have been scientifically proven, but I wouldn't like to see us throw the baby out with the shower water. A prospective randomized double-blind study to evaluate the effect of Dexamethasone in acute laryngo tracheitis. A randomised, placebo controlled trial. Fitzgerald D, Johnson M, McCrossin T et al.