Subglottic stenosis is characterized by the narrowing of your subglottis (a portion of your windpipe). The condition affects females almost exclusively and causes hoarseness, wheezing and shortness of breath. Treatments range from close observation to steroid injections to surgery.
Subglottic stenosis is a condition in which your subglottis (a portion of your windpipe, just below your vocal cords) narrows. It’s usually characterized by inflammation and fibrosis (scar tissue) in the area. Sometimes, the condition is called idiopathic subglottic stenosis (iSGS). The term idiopathic means that experts don’t know the underlying cause.
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There are two main types of subglottic stenosis — congenital and acquired:
Subglottic stenosis can affect newborn babies, children and adults. People are either born with the condition or they develop it as a complication later on. Statistically, idiopathic subglottic stenosis affects females almost exclusively (98%) — most of them white (95%).
Subglottic stenosis is considered a rare disease. It occurs in about 1 out of every 400,000 people.
People with subglottic stenosis may experience a few different symptoms, including:
Some subglottic stenosis symptoms are similar to those of asthma, bronchitis or other bronchi-related conditions. For this reason, some people with subglottic stenosis are misdiagnosed.
Babies with subglottic stenosis often exhibit noisy breathing. Additional symptoms may include:
Though subglottic stenosis can be caused by trauma or complications of intubation, the causes of many cases are not known. This is called idiopathic subglottic stenosis. Researchers don’t know exactly what causes idiopathic subglottic stenosis. Though there are many theories that take genetic, environmental and immunologic factors into account, there isn’t currently enough evidence to provide conclusive answers.
Your healthcare provider will perform a physical examination and ask you about your symptoms. If they suspect subglottic stenosis, they may perform a number of tests, which may include:
Subglottic stenosis is most commonly treated with steroid injections or surgery. In some mild cases, periodic observation is sufficient to see if narrowing of your airway worsens. Because subglottic stenosis is a rare disorder, there is no standardized treatment. Healthcare providers take many factors into account when treating it, including age and severity of the condition.
Steroid injections are sometimes recommended after endoscopic dilations, or as a first line of treatment in some select people. During this in-office procedure, your healthcare provider numbs your neck, windpipe and nose with local anesthesia. Next, a laryngoscope (a special camera used to look at your voice box and windpipe) is placed through your nose to view the subglottis. A needle is then placed through your neck and into your airway to inject steroid medications. This procedure is only recommended for people who can tolerate a small amount of airway swelling. Furthermore, a series of three injections are typically needed, given every four to six weeks.
Subglottic stenosis is surgically treated using one of four methods:
Yes, sometimes. Mild cases of subglottic stenosis can potentially go away without treatment. That’s why close monitoring is often recommended in these instances.
Because all underlying causes of subglottic stenosis have not been discovered, there is no known way to fully prevent the condition from developing.
Severe cases of subglottic stenosis can be dangerous and life-limiting. Therefore, it’s important to seek immediate medical attention if you develop symptoms.
Yes. Most cases of subglottic stenosis can be treated with prompt and proper treatment. However, recurrences do occur and may require multiple treatments down the road.
Anytime you have difficulty breathing, call your healthcare provider right away. They may refer you to an ear, nose and throat specialist for testing.
A note from Cleveland Clinic
Whether you have a baby who was born with subglottic stenosis or you developed the condition yourself later in life, it can be challenging to determine which treatment is right for you. Your healthcare provider can answer any questions you have and offer insight regarding your long-term health and recovery.
Last reviewed by a Cleveland Clinic medical professional on 11/01/2021.
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