Stoelben Erich
Thoraxklinik, St. Hildegardiskrankenhaus, Köln, Deutschland.
Zentralbl Chir. 2024 Jun;149(3):308-314. doi: 10.1055/a-2241-0616. Epub 2024 Feb 15.
Idiopathic subglottic stenosis is a circular scarred narrowing of the airway at the transition from the cricoid cartilage to the trachea. The stenosis is found radiologically and endoscopically at the level of the cricoid cartilage without involvement of the cricoid or tracheal cartilage itself. The disease practically only affects women between the ages of 20 and 60. The same clinical picture occurs in granulomatosis with polyangiitis and less frequently in other autoimmune diseases, where it requires systemic treatment. The clinical picture usually begins insidiously with coughing and sputum production and leads to dyspnoea and a restricted cough. As the course is insidious and the patients are otherwise healthy, the symptoms are often misinterpreted and the diagnosis is delayed. Treatment consists of local measures, ranging from dilatation and laser surgical resection, sometimes with local application of medication to inhibit the proliferation of new scar tissue, to laryngotracheal resection of varying degrees. The disease is located in the border area between the trachea and larynx and the patients are therefore treated by ENT medicine, pneumology and thoracic surgery.
特发性声门下狭窄是环状软骨至气管移行处气道的环形瘢痕性狭窄。放射学和内镜检查发现狭窄位于环状软骨水平,环状软骨或气管软骨本身未受累。该疾病实际上仅影响20至60岁的女性。肉芽肿性多血管炎也会出现相同的临床表现,在其他自身免疫性疾病中较少见,后者需要进行全身治疗。临床表现通常隐匿起病,伴有咳嗽和咳痰,进而导致呼吸困难和咳嗽受限。由于病程隐匿且患者其他方面健康,症状常被误诊,诊断往往延迟。治疗包括局部措施,从扩张和激光手术切除,有时局部应用抑制新瘢痕组织增生的药物,到不同程度的喉气管切除术。该疾病位于气管和喉部的交界区域,因此患者由耳鼻喉科、肺病科和胸外科进行治疗。