Subglottic Stenosis in Adults Workup

Updated: Jul 19, 2018
  • Author: James D Garnett, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Laboratory Studies

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  • In the absence of a history of prior trauma or when suggested by other findings, evaluate for inflammatory or infectious causes, including the following:

    • Wegener granulomatosis

    • Relapsing polychondritis

    • Syphilis

    • Tuberculosis

    • Sarcoidosis

    • Leprosy

    • Diphtheria

    • Scleroma

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Imaging Studies

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  • Radiography

    • Standard chest radiographs can often provide a great deal of information regarding the tracheal air column.

    • Anteroposterior filtered tracheal views and lateral soft tissue views of the neck provide specific information regarding the glottic/subglottic air column.

  • MRI is useful in evaluating length and width of the stenotic region by means of coronal and sagittal views.

  • CT scan

    • CT scanning is not as helpful as MRI because its views are generally only in the axial plane.

    • Thin cuts (1 mm) with sagittal and/or coronal reconstructions may be helpful, however. This is the preferred initial imaging study of the author.

    • New software allows virtual bronchoscopy, which may be helpful in assessing the airway and surgical planning prior to actually performing a procedure.

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Other Tests

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  • Flow-volume loops do not offer more specific information regarding stenosis than what is gained from imaging. However, flow-volume loops may be helpful in monitoring for restenosis after intervention.

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Diagnostic Procedures

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  • Videostrobolaryngoscopy is extremely helpful in evaluating the glottic and supraglottic larynx for possible concomitant injury.

  • Visualization of the larynx by flexible fiberoptic or rigid telescopic (90- or 70-degree scopes) in the clinic is crucial to the evaluation of airway lesions.

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