Adult Supraglottic Stenosis: Etiology and Management.
Supraglottic stenosis is a rare entity, which is more common in females, and trauma is the most common cause for it. Dysphagia, dysphonia, dyspnea and stridor are the common symptoms of supraglottic stenosis.
Non-symptomatic cases can be managed by observation, and symptomatic cases with sever airway obstruction may need a tracheostomy; some cases may need nasogastric tube to relieve dysphagia.
Endoscopic approach using carbon dioxide laser is the most common procedure used to treat supraglottic stenosis, supraglottic laryngectomy is
only indicated for severe supraglottic stenosis.
Supraglottic stenosis has high rate of recurrence and may need multiple surgical procedures. Supraglottic stenosis has a better prognosis than
glottis and subglottic stenosis with successful treatment rate up to 83%.
Presenting symptoms may include dysphagia, dysphonia, shortness of breath, stridor and potentially life-threatening airway obstruction. There is a controversy about the optimal treatment of supraglottic stenosis.
Historically, open supraglottic laryngectomy was the treatment of choice; however, this was associated by high morbidity connected to chronic aspiration and poor wound healing. Recently, endoscopic approach is more favorable because it is more conservative and associated with
less morbidity.
All adult patients diagnosed with supraglottic stenosis following any cause were included in the study. Neck malignancies, pediatric cases less than 12 years and burns of the neck.
Sixty patients out of them had isolated supraglottic stenosis, while the other 12 patients had multiple sites laryngeal stenosis. Sixty-five patients of them had a tracheostomy, while the other 7 patients did not have tracheostomy.
Endoscopic approaches are more favorable than open approaches, but open procedures is usually recommend for difficult and complex cases.
Otolaryngol Open J. 2016; 2(5): 132-140. doi: 10.17140/OTLOJ-2-129