Histopathology of congenital subglottic stenosis

Abstract

Three patients with congenital subglottic stenosis are presented and whole organ serial-section studies of their larynges are discussed. A superiorly displaced first tracheal ring is observed to form a cartilaginous subglottic stenosis in one. This "trapped first ring" is demonstrated in horizontal, sagittal and coronal planes. Subglottic stenosis is a clinical diagnosis which describes multifarious histopathological forms of narrowing within the subglottic larynx.

Partial cricotracheal resection for congenital subglottic stenosis in children: The effect of concomitant anomalies

“…In the cartilaginous type of congenital SGS, a small normally shaped cricoid cartilage or an abnormally shaped cricoid is seen. Tucker et al first described the elliptical cricoid cartilage, which is the most frequently encountered abnormal shape that causes congenital subglottic stenosis [2]. In our series of 41 patients, the elliptical cricoid was seen in the majority (73%), similar to descriptions in the literature.…”

“…This is also the most common laryngeal anomaly necessitating tracheostomy in children less than 1 year of age [2]. Subglottic stenosis can be classified into congenital, mixed or acquired types.…”

Congenital Malformations of the Larynx

“…The greatest area of narrowing is typically 2-3 mm below the vocal cords. Congenital SGS can be classifi ed as membranous or cartilaginous and occurs when there is no history of intubation or surgical trauma [ 38 ].…”

Developmental Aspects of the Upper Airway: Report from an NHLBI Workshop, March 5-6, 2009

“…A detailed description of the anatomy of the cartilaginous support structures of the larynx and trachea can be found in Hollinshead (13). The current understanding of the embryology of the larynx and trachea is limited to descriptive anatomic studies in the mouse and postmortem studies in human embryos (14)(15)(16)(17)(18)(19)(20)(21). Acquired upper airway abnormalities.…”

“…The exact rate of occurrence of acquired airway anomalies is unknown, but has increased because of the improved survival of premature infants who require prolonged intubation for ventilatory support. Histologic examination of stenotic segments often reveals a combination of luminal soft tissue thickening with concomitant cartilaginous deformity (thickening or ring fracture with loss of structural support) (15,16,22). Current investigation into the field of subglottic/tracheal luminal growth suggests a role for epithelial-driven expansion of the underlying cartilage (23).…”