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 4th 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 requires a multidisciplinary approach to management, including, but not limited to, pulmonologists, intensivists, otolaryngologists, and gastroenterologists, as well as speech-language pathologists and cardiothoracic surgeons. Determining the etiology of LTS is critical, as it informs management and provides prognostic information for the patient.