Subglottic stenosis

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  • Subglottic Stenosis is a narrowing of the trachea directly inferior to the vocal cords.
  • Causes:
    • 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]


  • 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


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