Saldarriaga Carlos A, Choi Bryan
Emergency Department, Bayhealth Hospital, Dover, USA.
Cureus. 2024 Dec 28;16(12):e76525. doi: 10.7759/cureus.76525. eCollection 2024 Dec.
Subglottic stenosis (SGS) presents a rare, yet challenging condition characterized by airway obstruction below the glottis, with diverse etiologies ranging from congenital to acquired factors like intubation or autoimmune diseases. Diagnosis and management of SGS during pregnancy are particularly complex due to limited literature and diagnostic consensus. This article presents a case of a 26-year-old pregnant woman presenting with escalating dyspnea and stridor attributed to SGS, most likely secondary to idiopathic etiology. Initial assessments, including a CT scan and fiberoptic laryngoscopy, confirmed the diagnosis of SGS showing a narrow subglottic trachea. Given the complexity of the case, she was transferred to a tertiary care center where she underwent CO2 laser excision, balloon dilation, and submucosal Triamcinolone injection. Pre and postoperatively, the patient was managed with corticosteroids, antibiotics, and bronchodilators. Her condition improved significantly, as evidenced by a follow-up strobovideolaryngoscopy on day 15, which showed a symmetric vocal fold, adequate vibratory motion, and widely patent subglottic larynx. This report emphasizes the importance of tailored, multidisciplinary management of SGS during pregnancy, with endoscopic resection and adjuvant therapies proving to be effective interventions. Regular follow-up is crucial due to the potential for recurrence within three years post-treatment.
声门下狭窄（SGS）是一种罕见但具有挑战性的疾病，其特征为声门以下气道梗阻，病因多样，从先天性因素到诸如插管或自身免疫性疾病等后天性因素。由于相关文献有限且诊断共识不足，孕期SGS的诊断和管理尤为复杂。本文介绍了一例26岁的孕妇，因SGS出现进行性加重的呼吸困难和喘鸣，最可能继发于特发性病因。包括CT扫描和纤维喉镜检查在内的初步评估确诊为SGS，显示声门下气管狭窄。鉴于病例的复杂性，她被转至三级医疗中心，在那里接受了二氧化碳激光切除、球囊扩张和曲安奈德黏膜下注射治疗。术前和术后，患者接受了皮质类固醇、抗生素和支气管扩张剂治疗。第15天的频闪喉镜检查显示声带对称、振动运动正常且声门下喉腔广泛通畅，这证明她的病情显著改善。本报告强调了孕期SGS进行个性化多学科管理的重要性，内镜切除和辅助治疗被证明是有效的干预措施。由于治疗后三年内有复发的可能，定期随访至关重要。
