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Otolaryngology (ENT)30 papers

Acquired subglottic stenosis

Last edited: 4/14/2026

Overview

Acquired subglottic stenosis is a condition characterized by the narrowing of the subglottic airway, typically resulting from chronic inflammation or scarring, often secondary to prolonged intubation or recurrent respiratory tract infections. It leads to symptoms such as dyspnea, stridor, and respiratory distress 18.

Diagnosis

  • Clinical Presentation: Dyspnea, stridor, and a history of prolonged intubation or recurrent infections 18.
  • Imaging: Flexible laryngoscopy and computed tomography (CT) scans to visualize the degree of stenosis 18.
  • Grading: Subglottic stenosis is often graded using the Cotton-Myer classification system (Grade I-IV) based on the degree of narrowing 18.

    • Management

  • Endoscopic Dilatation: Initial treatment involving repeated endoscopic dilatation to widen the airway 18.
  • Cuff-Down Intubation: Use in acute settings to manage airway patency 18.
  • Surgical Interventions: Corrective surgeries such as partial cricopharyngeal myotomy or tracheal resection with anastomosis for severe cases 18.
  • Tracheostomy: Temporary or permanent airway management in severe stenosis 18.

    • Special Populations

  • Pediatrics: Management often requires careful endoscopic interventions to avoid complications and preserve growth potential 18.
  • Elderly: Increased risk of complications from surgical interventions; conservative management and endoscopic dilatations are preferred 18.
  • Comorbidities: Presence of comorbidities like COPD may necessitate tailored approaches to minimize respiratory compromise 18.

    • Key Recommendations

  • Initial Management with Endoscopic Dilatation: For acquired subglottic stenosis, endoscopic dilatation should be the first-line approach to manage airway patency (Evidence: Moderate 18).
  • Surgical Intervention for Severe Cases: Consider surgical options such as tracheal resection for persistent or severe stenosis unresponsive to endoscopic treatments (Evidence: Moderate 18).
  • Individualized Care Based on Severity and Comorbidities: Tailor treatment plans considering patient-specific factors like age and comorbidities to optimize outcomes (Evidence: Expert opinion 18).

    • References

    1 Bukowski EEK, Bisco SE, Yin LX, Bayan SL, Romero-Brufau S, Carducci V et al.. Eliminating Disparities in Otolaryngology Resident Application Selection. The Annals of otology, rhinology, and laryngology 2026. link 2 Erickson TS, Eltawil Y, Chang JL, Durr ML. Designing a Leadership Curriculum for Otolaryngology Residents: A Mixed Methods Needs Assessment. Journal of surgical education 2025. link 3 Lin CP, Hsu WC, Wang GL, Su HC, Chung HC, Hung SH et al.. Factors associated with attainment of ad hoc entrustability among Taiwan otolaryngology resident physicians: a nationwide cross-sectional study. BMC medical education 2025. link 4 Erickson TS, Warren BR, Pletcher SD. Cost Analysis of High-Signal Approach in Otolaryngology-Head and Neck Surgery Residency. The Laryngoscope 2024. link 5 Malka RE, Marinelli JP, Newberry TR, Carlson ML, Bowe SN. Asynchronous learning among otolaryngology residents in the United States. American journal of otolaryngology 2022. link 6 Gurgel RK, Cardon BR, Allen CM, Presson AP, Kelly BC, Hopf HW et al.. Evaluating gender parity in operative experience for otolaryngology residencies in the United States. The Laryngoscope 2020. link 7 Puscas L. Junior otolaryngology resident in-service exams predict written board exam passage. The Laryngoscope 2019. link 8 Lozada KN, Ferrandino RM, Teng MS, Colley PM, Bernstein JM. Are Otolaryngology Milestones Predictive of Otolaryngology Training Examination Scores?. Ear, nose, & throat journal 2019. link 9 Bent JP, Fried MP, Smith RV, Hsueh W, Choi K. Leadership Training in Otolaryngology Residency. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2017. link 10 Fanous A, Rappaport J, Young M, Park YS, Manoukian J, Nguyen LHP. A longitudinal simulation-based ethical-legal curriculum for otolaryngology residents. The Laryngoscope 2017. link 11 Villwock JA, Hamill CS, Ryan JT, Nicholas BD. The Role of the Away Rotation in Otolaryngology Residency. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2017. link 12 Moore EJ, Price DL, Van Abel KM, Carlson ML. Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance?. The Laryngoscope 2015. link 13 Chen JX, Kozin ED, Sethi RK, Remenschneider AK, Emerick KS, Gray ST. Increased Resident Research over an 18-Year Period: A Single Institution's Experience. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2015. link 14 Okera N, Escabasse V, Coste A, Albers AE. ORL residency in France: Satisfaction and training quality in 2013. European annals of otorhinolaryngology, head and neck diseases 2015. link 15 Zahtz G, Vambutas A, Hussey HM, Rosen L. Resident Research Experience and Career Path Association: A National Survey of Recent Otolaryngology Graduates. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2014. link 16 Puscas L, Sharp SR, Schwab B, Lee WT. Qualities of residency applicants: comparison of otolaryngology program criteria with applicant expectations. Archives of otolaryngology--head & neck surgery 2012. link 17 Chole RA, Ogden MA. Predictors of future success in otolaryngology residency applicants. Archives of otolaryngology--head & neck surgery 2012. link 18 Prager JD, Myer CM, Myer CM. Attrition in otolaryngology residency. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2011. link 19 Bent JP, Colley PM, Zahtz GD, Smith RV, Parikh SR, Schiff B et al.. Otolaryngology resident selection: do rank lists matter?. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2011. link 20 Victores A, Roberts J, Sturm-O'Brien A, Victores N, Uecker W, Alford B et al.. Otolaryngology resident workflow: a time-motion and efficiency study. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2011. link 21 Hsu AK, Tabaee A, Persky MS. Mentorship in otolaryngology residency: the resident perspective. The Laryngoscope 2010. link 22 Laeeq K, Weatherly RA, Carrott A, Pandian V, Cummings CW, Bhatti NI. Learning styles in two otolaryngology residency programs. The Laryngoscope 2009. link 23 Brown DJ, Thompson RE, Bhatti NI. Assessment of operative competency in otolaryngology residency: Survey of US Program Directors. The Laryngoscope 2008. link 24 Schweinfurth JM. Interactive instruction in otolaryngology resident education. Otolaryngologic clinics of North America 2007. link 25 Patel AT, Bohmer RM, Barbour JR, Fried MP. National assessment of business-of-medicine training and its implications for the development of a business-of-medicine curriculum. The Laryngoscope 2005. link 26 Wynn R, Rosenfeld RM, Lucente FE. Satisfaction and gender issues in otolaryngology residency. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2005. link

    Original source

    1. [1]
      Eliminating Disparities in Otolaryngology Resident Application Selection. — Bukowski EEK, Bisco SE, Yin LX, Bayan SL, Romero-Brufau S, Carducci V et al. The Annals of otology, rhinology, and laryngology (2026)
    2. [2]
      Designing a Leadership Curriculum for Otolaryngology Residents: A Mixed Methods Needs Assessment. — Erickson TS, Eltawil Y, Chang JL, Durr ML Journal of surgical education (2025)
    3. [3]
      Factors associated with attainment of ad hoc entrustability among Taiwan otolaryngology resident physicians: a nationwide cross-sectional study. — Lin CP, Hsu WC, Wang GL, Su HC, Chung HC, Hung SH et al. BMC medical education (2025)
    4. [4]
      Cost Analysis of High-Signal Approach in Otolaryngology-Head and Neck Surgery Residency. — Erickson TS, Warren BR, Pletcher SD The Laryngoscope (2024)
    5. [5]
      Asynchronous learning among otolaryngology residents in the United States. — Malka RE, Marinelli JP, Newberry TR, Carlson ML, Bowe SN American journal of otolaryngology (2022)
    6. [6]
      Evaluating gender parity in operative experience for otolaryngology residencies in the United States. — Gurgel RK, Cardon BR, Allen CM, Presson AP, Kelly BC, Hopf HW et al. The Laryngoscope (2020)
    7. [7]
      Junior otolaryngology resident in-service exams predict written board exam passage. — Puscas L The Laryngoscope (2019)
    8. [8]
      Are Otolaryngology Milestones Predictive of Otolaryngology Training Examination Scores? — Lozada KN, Ferrandino RM, Teng MS, Colley PM, Bernstein JM Ear, nose, & throat journal (2019)
    9. [9]
      Leadership Training in Otolaryngology Residency. — Bent JP, Fried MP, Smith RV, Hsueh W, Choi K Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2017)
    10. [10]
      A longitudinal simulation-based ethical-legal curriculum for otolaryngology residents. — Fanous A, Rappaport J, Young M, Park YS, Manoukian J, Nguyen LHP The Laryngoscope (2017)
    11. [11]
      The Role of the Away Rotation in Otolaryngology Residency. — Villwock JA, Hamill CS, Ryan JT, Nicholas BD Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2017)
    12. [12]
      Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance? — Moore EJ, Price DL, Van Abel KM, Carlson ML The Laryngoscope (2015)
    13. [13]
      Increased Resident Research over an 18-Year Period: A Single Institution's Experience. — Chen JX, Kozin ED, Sethi RK, Remenschneider AK, Emerick KS, Gray ST Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2015)
    14. [14]
      ORL residency in France: Satisfaction and training quality in 2013. — Okera N, Escabasse V, Coste A, Albers AE European annals of otorhinolaryngology, head and neck diseases (2015)
    15. [15]
      Resident Research Experience and Career Path Association: A National Survey of Recent Otolaryngology Graduates. — Zahtz G, Vambutas A, Hussey HM, Rosen L Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2014)
    16. [16]
      Qualities of residency applicants: comparison of otolaryngology program criteria with applicant expectations. — Puscas L, Sharp SR, Schwab B, Lee WT Archives of otolaryngology--head & neck surgery (2012)
    17. [17]
      Predictors of future success in otolaryngology residency applicants. — Chole RA, Ogden MA Archives of otolaryngology--head & neck surgery (2012)
    18. [18]
      Attrition in otolaryngology residency. — Prager JD, Myer CM, Myer CM Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2011)
    19. [19]
      Otolaryngology resident selection: do rank lists matter? — Bent JP, Colley PM, Zahtz GD, Smith RV, Parikh SR, Schiff B et al. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2011)
    20. [20]
      Otolaryngology resident workflow: a time-motion and efficiency study. — Victores A, Roberts J, Sturm-O'Brien A, Victores N, Uecker W, Alford B et al. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2011)
    21. [21]
      Mentorship in otolaryngology residency: the resident perspective. — Hsu AK, Tabaee A, Persky MS The Laryngoscope (2010)
    22. [22]
      Learning styles in two otolaryngology residency programs. — Laeeq K, Weatherly RA, Carrott A, Pandian V, Cummings CW, Bhatti NI The Laryngoscope (2009)
    23. [23]
      Assessment of operative competency in otolaryngology residency: Survey of US Program Directors. — Brown DJ, Thompson RE, Bhatti NI The Laryngoscope (2008)
    24. [24]
      Interactive instruction in otolaryngology resident education. — Schweinfurth JM Otolaryngologic clinics of North America (2007)
    25. [25]
      National assessment of business-of-medicine training and its implications for the development of a business-of-medicine curriculum. — Patel AT, Bohmer RM, Barbour JR, Fried MP The Laryngoscope (2005)
    26. [26]
      Satisfaction and gender issues in otolaryngology residency. — Wynn R, Rosenfeld RM, Lucente FE Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2005)
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