Subglottic stenosis

Revision as of 11:50, 10 August 2017 by Rossdonaldson1 (talk | contribs) (Differential Diagnosis)


  • A narrowing of the trachea directly inferior to the vocal cords


  • Idiopathic (more likely to affect females)
  • Congenital abnormality in newborns
  • Past mechanical trauma to the airway (intubation or surgery)
  • Autoimmune disorders
  • Wegener granulomatosis/ GPA - Approximately 36% of patients with GPA develop subglottic stenosis [1]
  • Rheumatoid Arthritis
  • Sarcoidosis

Clinical Features

  • Tachypnea/ Dyspnea/ Hypoxia
  • Inspiratory stridor
  • Hoarseness/ Dysphonia
  • Respiratory accessory muscle usage
  • Cough
  • "Tightness" in the neck
  • Patients with history of greater than 1 week of intubation

Differential Diagnosis

  • Vocal cord paralysis
  • Subglottic hemangioma
  • Tumor (metastatic, benign airway tumors, primary endoluminal malignancies)
  • Vascular ring
  • Smoke injury
  • Chemical burn
  • Foreign body
  • Tracheal stenosis (not at the subglottic region)
  • Tracheomalacia[2]



Infectious Disorders


Neoplastic Disorders

  • Neoplasms/tumors

Allergic and Auto-Immune Disorders

  • Spasmodic/tracheobronchitis
  • Angioedema/Angioneurotic edema

Metabolic, Storage Disorders

  • Cerebral Gaucher's of infants (acute)
  • Tracheobronchial amyloidosis

Biochemical Disorders

Congenital, Developmental Disorders

Psychiatric Disorders

  • Somatization disorder

Anatomical or Mechanical

Vegetative, Autonomic, Endocrine Disorders


Chronic Pediatric Conditions


  • Direct visualization via scope Subglottic stenosis2.jpg
  • CT Neck


  • ENT referral or immediate securing of airway dependent upon respiratory distress
  • Humidified oxygen
  • Proton pump inhibitor
  • Systemic steroids
  • Treat underlying disorder if caused by autoimmune disorder

Definitive Management:

  • Dilation
  • Crichotracheal resection
  • Tracheotomy


  • Admit

See Also

External Links


  1. Taylor SC, Clayburgh DR, Rosenbaum JT, Schindler JS. Progression and management of Wegener's granulomatosis in the head and neck. Laryngoscope 2012; 122:1695.
  2. Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004
  3. Vocal Cord Dysfunction on Internet Book of Critical Care
  4. Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004