Subglottic stenosis is a condition characterized by narrowing of the airway beneath the vocal cords and above the trachea at the level of the cricoid cartilage. It can occur in both children and adults as a congenital, acquired, or idiopathic condition. Congenital cases are rare and often occur concurrent with an underlying syndrome, presenting in neonates or young children. Acquired cases are typically caused by prolonged intubation or tracheostomy with inappropriate location near the larynx. Some cases of subglottic stenosis are caused by systemic vascular inflammatory diseases such as granulomatosis with polyangiitis.
Most patients complain of shortness of breath, respiratory distress, or decreased exercise tolerance. If inflammation extends to the vocal cords, patients can present with a hoarse voice.
The severity of subglottic stenosis is graded on a scale of 1 through 4:
Grade 1 stenosis refers to 0%-50% luminal narrowing
Grade 2 stenosis refers to 51%-70% luminal narrowing
Grade 3 stenosis refers to 71%-99% luminal narrowing
Grade 4 stenosis refers to 100% luminal narrowing
Prognosis and treatment modalities vary depending on etiology and grade.
ICD10CM: J38.6 – Stenosis of larynx
SNOMEDCT: 22668006 – Subglottic stenosis
Differential Diagnosis & Pitfalls
Idiopathic subglottic stenosis
Intubation trauma from prolonged or too-large endotracheal tube