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Subglottic Stenosis

Subglottic stenosis is a scar-like narrowing of the of the windpipe below the vocal cords (subglottis). When occurring in adults, subglottic stenosis can result in a high-pitched sound made while breathing in or out that's sometimes misdiagnosed as asthma.. Surgery is necessary to remove the scar and increase the size of the windpipe.

Signs and Symptoms

Noisy breathing or stridor is a common symptom associated with subglottic stenosis. It may also cause shortness of breath with exertion, such as walking up stairs. Some people with the condition may also experience difficulty catching their breath after mild or moderate activity. Additional symptoms may include:

  • Persistent hoarseness
  • Sensation of mucus ‘caught’ within the throat
  • Difficulty breathing at rest

Diagnosing Subglottic Stenosis

Diagnosis is often delayed since many patients with the condition are first incorrectly treated for asthma or bronchitis instead. When treatments for those respiratory conditions are found not to be effective, further diagnostic testing is usually needed to confirm subglottic stenosis. Pulmonary function tests, where a patient breathes in and out of a machine to test their respiratory capabilities, may help achieve a positive diagnosis of subglottic stenosis.

Examination of the trachea, or windpipe is often accomplished with the application of a topical numbing medication rather than use of general anesthesia. A camera if then passed through the nose to capture and record a clear view of the affected area to diagnose subglottic stenosis. A CT scan of the neck can also confirm the condition.

Subglottic Stenosis Treatment

There are different treatment options for patients. Endoscopic surgery, performed through the mouth in a minimally invasive fashion is performed as an outpatient procedure. A laser is used to resect the scar and a balloon is placed to dilate the airway. Steroids and other medications are then applied to prevent the stenosis from recurring. Anti-reflux drugs may also help manage the condition.

Tracheal resection may be performed. During this surgery the narrowed portion of the airway is removed through a cut on the neck. The remaining portions of the trachea are connected to one another.

The reason for subglottic stenosis can vary. It may be related to an underlying autoimmune or inflammatory disease. It can also result from intubation with a breathing tube for other health concerns.