Subglottic Stenosis
Subglottic stenosis is a condition in which the airway just below the vocal cords becomes narrowed, making it difficult for a child to breathe comfortably. This narrowing can be congenital (present at birth) or acquired, often as a result of prolonged intubation (having a breathing tube in place during illness or surgery). The subglottic area is already the narrowest part of a child’s airway, so even a small amount of swelling or scarring can lead to significant symptoms.
Signs and symptoms of subglottic stenosis often include stridor (a high-pitched, noisy breathing sound), particularly when the child is active, upset or during a respiratory infection. Other symptoms may include a weak or hoarse cry, chronic cough, frequent respiratory infections, difficulty feeding or trouble gaining weight. In more severe cases, children may have labored breathing or require frequent medical attention for what seems like recurrent croup or asthma that doesn’t improve with typical treatments.
Diagnosis involves a thorough history and physical exam, often followed by imaging or direct airway examination. The most definitive way to evaluate subglottic stenosis is through laryngoscopy and bronchoscopy, procedures performed under general anesthesia by our surgeons at ENT for Kids. These allow our doctors to see the degree and location of narrowing in the airway guiding treatment.
Management of subglottic stenosis depends on its cause and severity. Mild cases may be observed or treated with medications such as inhaled steroids to reduce inflammation. If intervention is needed, endoscopic procedures like balloon dilation or laser treatment can be used to widen the airway without open surgery. These are less invasive and often used for moderate cases or in very young children. In more severe or persistent cases, open surgical repair may be necessary. One procedure option is a laryngotracheal reconstruction (LTR), in which cartilage grafts are used to expand the airway. Our surgeons at ENT for Kids have the most experience in North Florida performing endoscopic and open airway reconstruction on children.
With proper treatment and follow-up, most children with subglottic stenosis can go on to breathe, speak and grow normally. If your child has persistent breathing difficulties or has had a history of prolonged intubation and now struggles with noisy breathing, please reach out to our team at ENT for Kids to request an appointment.