Subglottic Stenosis
Subglottic stenosis is when children have a hard time breathing because their airway is more narrow than normal.
What Is Subglottic Stenosis?
Subglottic stenosis is a condition where the airway is smaller than normal (narrow) below the vocal cords (Picture 1). This can cause problems with breathing, often made worse by illness or during activity.
There are 2 kinds of subglottic stenosis:
- Congenital – Your child was born with it. This happens because the airway did not grow the right way.
- Acquired – It happened after birth. This can happen after a severe infection or trauma. It can also happen after a tube is put down the airway to help with breathing (intubation).
What Are the Signs and Symptoms of Subglottic Stenosis?
Common symptoms of subglottic stenosis are:
- A high-pitched or noisy sound when your child breathes (stridor).
- Stridor can develop or get worse when they have a cold. Having a cold makes it harder to breathe and puts stress on the airway.
- Stridor may sound louder after your child exercises or is active.
- A hoarse or weak voice.
- Your child had croup several times before they’re 6 months old.
- Cannot gain weight.
How Is Subglottic Stenosis Diagnosed?
Your child will have a physical exam. Their doctor or health care provider will review their history and may order some or all of these tests:
- X-rays
- Flexible Laryngoscopy – A procedure done in the office to look at the upper airway, including the voice box and vocal cords. This allows vocal cord mobility to be looked at but does not look at the subglottis well.
- Laryngoscopy – A procedure performed with anesthesia to look at the entire voice box (larynx) including, the subglottis
- Bronchoscopy – A procedure performed with anesthesia to look at the trachea and airways.
How Is Subglottic Stenosis Treated?
Treatment depends on your child’s condition. Some children may get better on their own as they get older, some may need treatment.
- Mild cases can usually be watched carefully or treated by taking medicine or stretching the airway wider.
- In severe cases, your child may need surgery to make the airway larger. This treatment may require the placement of a trach tube in the airway. This is called a tracheostomy. It will help your child breathe better by going past the narrow part of the airway until it can be enlarged.
When Should I Call the Doctor?
Call your child's doctor or health care provider if they:
- Have symptoms that get worse, are very tired, are hard to wake up, or look very sick.
- Have skin pulling in at their ribs (retractions) after each breath.
- Have wide (flared) nostrils while breathing.
- Are not gaining weight.
When Should I Call 911?
Call 911 or take your child to the closest emergency department if:
- It's hard for them to breathe, speak, or drink.
- Their lips or face turn a bluish color.
- They're drooling.
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