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Subglottic Stenosis

Narrowing of the airway below the vocal cords causing exertional dyspnea

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Subglottic Stenosis?

Subglottic stenosis is narrowing of the airway in the segment between the inferior surface of the true vocal cords and the lower border of the cricoid cartilage. Causes are congenital (immature cricoid), acquired post-intubation/tracheostomy, idiopathic (women in their 30s-50s), or autoimmune (granulomatosis with polyangiitis, sarcoidosis, relapsing polychondritis).

The Cotton-Myer grading system stratifies severity from grade I (less than 50 percent obstruction) to grade IV (no detectable lumen). Patients present with progressive dyspnea on exertion, biphasic stridor and recurrent croup-like episodes. Bronchoscopy provides definitive diagnosis and surgical planning.

Symptoms

Progressive dyspnea on exertion
Biphasic stridor (inspiratory and expiratory)
Hoarseness or voice changes
Recurrent croup-like episodes
Cough and exercise intolerance
Choking sensation
Cyanosis with severe stenosis
Inability to clear secretions

Risk Factors

Prior endotracheal intubation, especially prolonged
Prior tracheostomy
Granulomatosis with polyangiitis (Wegener)
Sarcoidosis or relapsing polychondritis
Gastroesophageal reflux disease
Inhalation injury (smoke, caustic)
Female sex (idiopathic form)
Congenital cricoid abnormalities

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Progressive shortness of breath
  • Audible noisy breathing (stridor)
  • Recurrent episodes diagnosed as asthma without bronchodilator response
  • History of prolonged intubation
  • Voice changes with breathing difficulty
  • Choking spells
  • Exercise intolerance worsening over weeks

Treatment Methods

01
Direct laryngoscopy and bronchoscopy for grading via Cotton-Myer system
02
Endoscopic balloon dilation for short, soft segment stenosis
03
CO2 or KTP laser radial cuts combined with dilation for thin webs
04
Intralesional triamcinolone or methylprednisolone injection during dilation
05
Cricotracheal resection with primary anastomosis for severe grade III-IV stenosis
06
Laryngotracheal reconstruction with cartilage graft expansion for complex pediatric cases
07
Aggressive proton-pump inhibitor therapy for reflux control
08
Systemic immunosuppression for autoimmune etiologies (cyclophosphamide, rituximab)
09
Long-term follow-up and repeat dilations for idiopathic disease

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.