Subglottic stenosis is airway narrowing below the vocal folds. Subglottic stenosis causes shortness of breath, especially during times of exertion. When severe, subglottic stenosis, causes noisy breathing during inspiration and expiration.
Subglottic stenosis. Beyond the normal vocal folds is a circular narrowing of the airway.
Causes of subglottic stenosis include:
Scar formed from the tip of a breathing tube
Wegener’s granulomatosis – a condition of blood vessel inflammation
Trauma, such as an inhalation burn injury
Idiopathic subglottic stenosis, or subglottic stenosis for an unknown reason, is a diagnosis made if their is no obvious cause. Patients with idiopathic subglottic stenosis are often young females aged 25-50 with no other significant history.
Symptoms of subglottic stenosis include:
Shortness of breath during exertion and sometimes at rest
Subglottic stenosis is a difficult diagnosis to make, as the subglottis is a difficult area for a physician to see and examine. Patients are often unsuccessfully treated for more common disorders such as asthma before the diagnosis of subglottic stenosis is made.
A laryngoscopy and bronchoscopy is used to diagnose subglottic stenosis. A camera is passed into the airway to look for narrowing. Previously this was performed in the operating room, but with advances in technology can be performed in the office after a patient breathes in local anesthesia.
A CT scan may also be used to evaluate the size of the airway and degree of narrowing.
Treatment for subglottic stenosis:
Treatment for subglottic stenosis enlarges the size of the airway, thus making breathing easier. In the operating room laryngoscopy is performed with the patient asleep. A laser is used to cut the narrowed portion of the airway from the inside. A high pressure balloon dilator is then used to expand the size of the airway. Steroids and other medications are applied to prevent scar formation. This entire procedure is performed through the mouth.
When balloon dilation is inadequate, open surgery can be performed. After making a skin incision in the neck the narrowed portion of the airway is resected. The normal airway is then reattached and sutured together.
A laryngotracheal reconstruction is a surgery in which a piece of cartilage is used to stent the airway open. This more commonly occurs when children are treated for subglottic stenosis.
Throatdisorder.com is an online resource for patients and physicians to learn more about common voice, swallowing, breathing and throat disorders. Throat complaints, from cough to cancer, are a common reason for patients to seek medical treatment. This website developed as a result of Dr. Sunil Verma's passions: that of education, patient care, and interest in technology.
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Didn’t feel care for left the office feeling discouraged, dr didn’t seem interested in finding out why I’m having my symptoms. From his opinion I’m fine. When a doctor wants to really help they’ll try all test possible to find the problem, instead he said I need to see a pain specialist and I left.
I couldn’t ask for a better experience with a Doctor and staff. Dr. Verma put me at ease and walked me through the Vocal fold injection process. He made it an easy experience and he was always informative and willing to answer questions. I felt heard and never rushed.
Dr. Verma is awesome. He takes the time to answer any questions or concerns you may have without making you feel rushed. He’s very skilled at what he does, and his staff is very friendly. I highly recommend him!!
Dr. Verma was warm, kind, spent adequate time, seemed incredibly knowledgeable. Despite not knowing exactly what I'm experiencing, he was confident in a course of action. His staff was very nice as well.
All the Dr's, Nurse's & Staffs of the UCI are amazing!! They are very polite, loving, kind, and all around great Team!! Special thanks to Doctor Verma for all the work that you're done for my dad. Our family sincerely appreciate all of you very much!!
Dr. Verma and his staff were totally professional. I came in from Palm Springs and it truly was worth the ride. I have what’s called a ZINKER. He had to put a tube down my nose to examine me. I didn’t feel a thing.Forgot to mention I’m a big baby. All in all it was a very good experience. Thank you Dr. Verma