Idiopathic Subglottic Stenosis

Question 1

Is idiopathic subglottic stenosis the most common cause of benign laryngotracheal stenosis?

Answer 1

No, 3rd

Question 2

Diagnostic criteria for Idiopathic subglottic stenosis

Answer 2

• Female
• No h/o significant laryngotracheal injury
• No h/o vasculitis
• Negative ACE and ANCA serum studies
• Lesion grossly involves subglottis
• Fibrosis must be restricted to lamina propria on histo

Question 3

What are examples of laryngotracheal injury that must be absent for Dx of idiopathic subglottic stenosis

Answer 3

• No h/o intubation or trach (or no occurrence of Sx w/in 2 yrs of event)
• No thyroid or anterior neck surg
• No neck RT
• No caustic or thermal injury to laryngotracheal complex
• No blunt/penetrating neck trauma

Question 4

What are the treatment options for ISS

Answer 4

1. cricotracheal resection (remove the fibrosis-forming tissue)
2. Multiple endoscopies to maintain a patent airway
   - Intralesional steroids
   - Laser
   - Balloon dilation
   - Temporary silastic stenting

Question 5

What percentage of pts can be managed with minimally invasive surgery?

Answer 5

78%

Nouraei 2013

Question 6

What is the 5 yr success rate for endoscopic tx of:

1. ISS subglottis only
2. ISS subglottis + glottis

Answer 6

1. 87.5%

2. 18.7%