Central Airway Obstruction: Diagnostic Challenges and Management Strategies in Subglottic Stenosis and Poly Chondrites with Case Studies
DOI:
https://doi.org/10.14738/bjhr.1201.18162Keywords:
Tracheal stenosis, endoscopic laser microsurgery, balloon dilatation, relapsing polychondritis, biologics, stentsAbstract
Tumours or strictures compressing the trachea /bronchial tree cause central airway obstruction (CAO). Subglottic stenosis are a cause of respiratory symptoms and distress. Idiopathic sub glottic stenosis (ISGS) is a rare disease occurring mainly in women and has a history of recurrences. Endoscopic laser microsurgery and balloon dilatation are used in the management of strictures. Recurring strictures may require tracheoplasty. Poly chondrites is a rare disorder causing poly arthritis and inflammation of cartilaginous tissue. Inflammatory changes in the lung cause tracheobronchomalacia (TBM) and lung collapse. Relapsing polychondritis (RP) effecting the airway is life threatening as there is dynamic airway closure during expiration. The medical therapy in RP includes steroids, disease modifying agents ( methotrexate) and biologics. Surgical interventions include tracheostomies and tracheobronchial stents for severe forms of the illness.
References
Murgu, Septimiu Dan, Katarine Egressy, Balaji Laxmanan, Guillermo Doblare, Rosamaria Ortiz-Comino, and D Kyle Hogarth. 2016. “Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-Related Obstruction.” Chest 150 (2): 426–41.
Borgia, Francesco, Roberta Giuffrida, Fabrizio Guarneri, and Serafinella P Cannavò. 2018. “Relapsing Polychondritis: An Updated Review.” Biomedicines 6 (3): 84.
Sanivarapu, Raghavendra R, and Fatima Anjum. 2024. “Laryngeal and Tracheal Stents.” In StatPearls [Internet]. StatPearls Publishing. 81
Alsalihi, Yusur, Natalie M Yousef, Sundeep Grewal, and Benjamin Teitelbaum. 2023. “Tracheomalacia in Adults: An Uncommon Cause of Dyspnea.” Cureus 15 (11).
Nikki, Kean. 2020. “A Look at the Latest Research on Subglottic Stenosis.” ENT Today, August 2020. https://www.enttoday.org/article/a-look-at-the-latest-research-on-subglottic-stenosis/. See also, Gelbard, Alexander, David O Francis, Vlad C Sandulache, John C Simmons, Donald T Donovan, and Julina Ongkasuwan. 2015. “Causes and Consequences of Adult Laryngotracheal Stenosis.” The Laryngoscope 125 (5): 1137–43.
Maronian, Nicole C, Patricia Waugh, Hafez Azadeh, and Allen Hillel. 2001. “Association of Laryngopharyngeal Reflux Disease and Subglottic Stenosis.” Annals of Otology, Rhinology & Laryngology 110 (7): 606–12.
Aravena, Carlos, Francisco A Almeida, Sanjay Mukhopadhyay, Subha Ghosh, Robert R Lorenz, Sudish C Murthy, and Atul C Mehta. 2020. “Idiopathic Subglottic Stenosis: A Review.” Journal of Thoracic Disease 12 (3): 1100.
Franco Jr, Ramon A. 2023. “Office Based Steroid Injections for Subglottic Stenosis.” Operative Techniques in Otolaryngology-Head and Neck Surgery 34 (2): 120–28.
Wijermars, Leonie GM, Carlijn EL Hoekstra, Thao TT Nguyen, Markus F Stevens, and Frederik G Dikkers. 2022. “New Treatment Strategy for Subglottic Stenosis Using the Trachealator, a Novel Non‐occlusive Balloon.” The Laryngoscope 132 (11): 2202.
Axtell, Andrea L, and Douglas J Mathisen. 2018. “Idiopathic Subglottic Stenosis: Techniques and Results.” Annals of Cardiothoracic Surgery 7 (2): 299.
Mertz, Phillip, Joshua Sparks, Dale Kobrin, Sandra Amara Ogbonnaya, Ecem Sevim, Clement Michet, Laurent Arnaud, and Marcela Ferrada. 2023. “Relapsing Polychondritis: Best Practice & Clinical Rheumatology.” Best Practice & Research Clinical Rheumatology, 101867.
Handa, Hiroshi, Seido Ooka, Jun Shimizu, Noboru Suzuki, and Masamichi Mineshita. 2023. “Evaluation of Airway Involvement and Treatment in Patients with Relapsing Polychondritis.” Scientific Reports 13 (1): 8307.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 B A Bulbulia, M R Ahmed
This work is licensed under a Creative Commons Attribution 4.0 International License.
