Laryngotracheal Stenosis

Excerpt

Laryngotracheal stenosis (LTS) is a narrowing of the upper airway between the larynx and the trachea with potentially devastating consequences, including respiratory failure, cardiopulmonary arrest, and death. The upper airway is comprised of the larynx, glottis, subglottic region, and trachea. The trachea is a cylindrical-shaped tube with an anterior cartilaginous wall formed by c-shaped rings and a posterior membranous wall. The trachea branches off into the right and left mainstem bronchi at the carina, which is at the level of the fourth thoracic vertebra (T4).

Laryngeal stenosis may occur as a result of trauma, related to endotracheal intubation or due to a neoplasm, autoimmune, or infectious process. It can be asymptomatic, or can lead to symptoms of upper airway obstruction.

Laryngeal narrowing from any cause calls for a multidisciplinary approach to management, including, but not limited to, pulmonologists, intensivists, otolaryngologists, and gastroenterologists as well as speech and language pathologists, and cardiothoracic surgeons. The determination of the etiology of the laryngotracheal stenosis is critical as it can drive the management and provide prognostic information to the patient.