Idiopathic Supraglottic Stenosis Refractory to Multiple Interventions Improved With Serial Office-based Steroid Injections

Hoffman, Matthew R.; Johnny, P.; Dailey, Seth H.

doi:10.1016/j.jvoice.2017.09.016

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…10 Although not previously reported for cases of laryngeal Crohn disease, CO2 laser resurfacing (''pepper pot'') techniques have been used to reduce airway redundancy and achieve decannulation in cases of laryngeal sarcoidosis 16 as well as idiopathic, nongranulomatous chronic supraglottitis. 17,18 In conclusion, we report a case of a pediatric patient who presented with severe supraglottic edema with evidence of nonnecrotizing granulomas. Overall workup was unremarkable, leaving isolated laryngeal sarcoidosis or inflammatory bowel disease as the leading diagnoses.…”

Section: Discussionmentioning

confidence: 81%

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Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

et al. 2020

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A 12-year-old male with a family history of inflammatory bowel disease presented with sleep-disordered breathing and was found to have chronic, granulomatous swelling of the supraglottic larynx. His airway was managed with tracheostomy, regular interval laryngeal steroid injections, supraglottoplasty, and “pepper pot” CO2 laser resurfacing leading to eventual decannulation. Due to the non-necrotic nature of the granulomatous inflammation, as well as the patient’s family history of inflammatory bowel disease, the leading diagnosis was Crohn disease, but isolated laryngeal sarcoidosis could not be ruled out. There are only 13 reported cases of laryngeal manifestations of Crohn disease in the literature, with only 2 cases occurring in pediatric patients. This case report adds to this body of literature and discusses strategies for managing granulomatous supraglottic edema when definitive diagnosis is not fully clear.

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Section: Discussionmentioning

confidence: 81%

“…10 Although not previously reported for cases of laryngeal Crohn disease, CO2 laser resurfacing (“pepper pot”) techniques have been used to reduce airway redundancy and achieve decannulation in cases of laryngeal sarcoidosis 16 as well as idiopathic, nongranulomatous chronic supraglottitis. 17,18…”

Section: Discussionmentioning

confidence: 99%

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

et al. 2020

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“…Hoffman et al 15 reported a patient with idiopathic supraglottic stenosis who experienced persistent disease despite multiple office‐based and operative interventions, whose disease is now better controlled with scheduled serial office‐based steroid injections. They proposed this new office‐based steroid injection treatment that may help induce regression of stenosis.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Z‐plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients

Yılmaz

2020

The Laryngoscope

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Objectives Supraglottic stenosis is a rare type of laryngeal stenosis that is caused by congenital laryngotracheal anomalies, iatrogenic instrumentation injuries, autoimmune disorders, infection, irradiation, chemical or thermal burns, and external blunt or penetrating trauma. The author presents his experience on nine patients using this new endoscopic surgical technique for treatment of supraglottic stenosis. Study Design Individual retrospective cohort study, tertiary referral center, university hospital. Methods All cases of supraglottic laryngeal stenosis treated during a 10‐year period at a tertiary academic medical center were reviewed. Nine patients with supraglottic stenosis treated with endoscopic uni‐ or bilateral z‐plasty technique were determined and presented. The etiology of stenosis was iatrogenic surgical trauma in seven patients, laryngeal fracture in one patient, and systemic lupus erythematosus in the other patient. Main outcome measures were respiratory function test results, absence of dyspnea on exertion, and decannulation if tracheotomy was present preoperatively. Results Seven patients with tracheotomy were decannulated 1 month after surgery. All nine patients had adequate airway and were dyspnea‐free. Their preop respiratory function test results improved significantly postoperatively (P < .05). Conclusion For supraglottic stenosis endoscopic surgery using mucosal flaps in the form of z‐plasty should be considered within the available surgical techniques. Although this type of surgery is highly successful, it is technically difficult to apply. Level of Evidence 4 Laryngoscope, 131:E534–E539, 2021

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“…Supraglottic stenosis is a rare condition caused by acute or chronic swelling of the supraglottic larynx. It can be induced by inflammation or irradiation, chronic scarring due to prolonged instrumentation, autoimmune disease, gastro-esophageal reflux disease, or idiopathic causes [1–3] . It results in asthma symptoms, warranting a differential diagnosis [4,5] …”

Section: Introductionmentioning

confidence: 99%

“…It can be induced by inflammation or irradiation, chronic scarring due to prolonged instrumentation, autoimmune disease, gastro-esophageal reflux disease, or idiopathic causes. [1][2][3] It results in asthma symptoms, warranting a differential diagnosis. [4,5] In patients with airway obstruction such as supraglottic stenosis, accurate assessment of the airway is essential for airway reestablishment.…”

Section: Introductionmentioning

confidence: 99%

Postlaryngectomy supraglottic stenosis revealed by three-dimensional computed tomography reconstruction

Chon¹,

Hong²,

Lee³

et al. 2022

Medicine

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Rationale: Supraglottic stenosis is a rare cause of airway obstruction. It can be induced by radiation, trauma, autoimmune diseases, or caustic exposure, and is often misdiagnosed as asthma. Detailed airway information is necessary to re-establish the normal functioning of the airway.Patient concerns: A 78-year-old woman with severe dyspnea and hypercarbia was scheduled for surgery to resolve airway obstruction, previously known as supraglottic stenosis.Diagnoses: To determine the exact internal shape of the stenotic lesion, we reconstructed three dimensional computed tomography (CT) images depicted a tubular supraglottic stenosis. Interventions:The patient underwent tracheotomy under monitored anesthesia care and local anesthesia, followed by general anesthesia. For long-term management of the patient, the otorhinolaryngologist excised the supraglottic stricture via micro-laryngeal surgery using a CO 2 laser and applied mitomycin to prevent further obstruction.Outcomes: The patient recovered uneventfully after anesthesia, and symptom due to supraglottic stenosis was improved.Lessons: During airway management of patients with postlaryngectomy supraglottic stenosis, three-dimensional reconstructed computed tomography images facilitate airway configuration in addition to endoscopy and other radiological findings.Abbreviations: ABGA = arterial blood gas analysis, CT = computed tomography, HFNC = high-flow nasal cannula, MAC = monitored anesthesia care.

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Idiopathic Supraglottic Stenosis Refractory to Multiple Interventions Improved With Serial Office-based Steroid Injections

Cited by 5 publications

References 8 publications

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

Endoscopic Z‐plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients

Postlaryngectomy supraglottic stenosis revealed by three-dimensional computed tomography reconstruction

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