Subglottic and Tracheal Stenosis Surgery

Subglottic and tracheal stenosis are conditions that impact the larynx (voice box) and/or the trachea (wind pipe). Scarring can narrow the space for the passage of air into the lungs causing breathing difficulty and often requiring surgical intervention for the management of this condition.

Pre-procedure Considerations 

Difficulty breathing and a noisy breathing may come from the throat and are most commonly the symptoms of airway stenosis. These symptoms are worsened by physical activity and the condition can also be associated with a delayed diagnosis or miss diagnosed as asthma. The diagnosis is often made by an otolaryngologist (ear nose and throat specialist) or pulmonologist (lung specialist) using a small flexible camera passed through the nose down to voice box or windpipe. These procedures, called flexible laryngoscopy and bronchoscopy, can be performed awake or under sedation. During these procedures the narrowed area of the voice box or windpipe can be seen. A CT scan x-ray test of the upper airway and lungs may also be helpful in the initial diagnosis of airway stenosis.

Summary of Subglottic and Tracheal Stenosis Surgery

Surgery is the standard treatment for airway narrowing. There are many surgical options, but they can be broken down into 2 main groups: endoscopic (through the mouth) and open (through the skin in the front of the neck). Surgery quickly improves breathing, but scarring can often returns slowly over months to years in some cases. The recurrence rate is much lower for open surgery, but open surgery also carries potential for more surgical complications.

As with surgery anywhere in the body, there is always the potential of complications occurring. These include, but are not limited to: Injuries to your tooth or teeth;  Swelling and/or cuts of your lips and/or the inside of your mouth/throat;  Temporary or permanent tongue numbness;  Temporary or permanent tongue weakness;  Change in taste;  Swelling of the bottom of your mouth or chin; Jaw discomfort, pain, tightness, or dislocation; Neck discomfort or pain; Temporary difficulty with swallowing; Bleeding; Persistent or worsening hoarseness after surgery; Possibility of additional surgeries on the vocal folds;  Airway obstruction requiring a breathing tube or possibly a tracheotomy; rupture of the upper airway/trachea; collapsed lung; Burns to exposed skin (if a laser is used during your procedure); Airway fire (if a laser is used during your procedure); need for further surgeries; failure to diagnose.

Post-Procedure Guidelines 

This surgery is typically a same day procedure without an overnight hospital stay required following the procedure. However, this depends on your overall health status and the specific type of procedure you are having. It is best to discuss this with your surgeon. As always, at the Voice and Swallowing Center, an individualized treatment plan will be implemented. You can resume your normal diet following the procedure unless indicated otherwise by your surgeon. Pain is fairly minimal after the surgery and can be usually controlled by over the counter acetaminophen or ibuprofen.