78. Endoscopic treatment of laryngeal stenosis in adults: A literature review
Main Article Content
Abstract
The purpose of this study was to evaluate the efficacy of endoscopic surgery in the treatment of adult laryngeal stenosis. This review incorporatespublications from the Pubmed and Google Scholar databases. The selection criteria were research involving endoscopic surgical procedures in the treatment of laryngeal stenosis.Twenty-six publicationsmet theinclusion criteria; 1182 patients were treated with techniques such as stenosis resection, mechanical dilation, corticosteroid injection, Mitomycin application, stent placement and flap generation. We investigated the characteristics and efficacy of the aforementioned approaches. Despite several controversies, the review concludes that endoscopic surgery for laryngeal stenosis is highly effective, minimally invasive, and minimizes the likelihood of repeat surgery.
Article Details
Keywords
Laryngeal stenosis, endoscopic treatment, adult
References
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7. Pan DR, Rosow DE. Office-based corticosteroid injections as adjuvant therapy for subglottic stenosis. Laryngoscope Investig Oto. 2019; 4(4): 414-419. doi:10.1002/lio2.284.
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11. Neevel AJ, Schuman AD, Morrison RJ, Hogikyan ND, Kupfer RA. Serial Intralesional Steroid Injection for Subglottic Stenosis: Systemic Side Effects and Impact on Surgery-Free Interval. OTO Open. 2021; 5(4): 2473974X211054842. doi:10.1177/2473974X211054842.
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13. Maldonado F, Loiselle A, DePew ZS, et al. Idiopathic subglottic stenosis: An evolving therapeutic algorithm: Idiopathic Subglottic Stenosis. The Laryngoscope. 2014; 124(2): 498-503. doi:10.1002/lary.24287.
14. Wehbi N, Gleadhill CME, Ahmadian D, Skirko JR, Yip HT. In-office serial intralesional steroid injection for subglottic stenosis: Case series of 14 patients with multiple etiologies. World J Otorhinolaryngol Head Neck Surg. 2024; 11(1): 17-22. doi:10.1002/wjo2.159.
15. Hoffman MR, Coughlin AR, Dailey SH. Serial office-based steroid injections for treatment of idiopathic subglottic stenosis. The Laryngoscope. 2017; 127(11): 2475-2481. doi:10.1002/lary.26682.
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17. Hoffman MR, Francis DO, Mai JP, Dailey SH. Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects. Ann Otol Rhinol Laryngol. 2020; 129(4): 361-368. doi:10.1177/0003489419889066.
18. Fijolek J, Wiatr E, Gawryluk D, et al. Intratracheal Dilation-injection Technique in the Treatment of Granulomatosis with Polyangiitis Patients with Subglottic Stenosis. J Rheumatol. 2016; 43(11): 2042-2048. doi:10.3899/jrheum.151355.
19. Shabani S, Hoffman MR, Brand WT, Dailey SH. Endoscopic Management of Idiopathic Subglottic Stenosis: Factors Affecting Inter-Dilation Interval. Ann Otol Rhinol Laryngol. 2017; 126(2): 96-102. doi:10.1177/0003489416675357.
20. Erlandsson A, Lundquist A, Olofsson K. Mapping quality of life after balloon dilatation in subglottic stenosis using Dyspnea index and Short Form Health Survey-36. Eur Arch Otorhinolaryngol. 2024; 281(7): 3701-3706. doi:10.1007/s00405-024-08667-0.
21. Wierzbicka M, Tokarski M, Puszczewicz M, Szyfter W. The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology. J Laryngol Otol. 2016; 130(7): 674-679. doi:10.1017/S0022215116001122.
22. Enver N, Ramaswamy A, Pitman MJ. How I Do It: A Novel Technique for Endoscopic Placement of Stent in Management of Anterior Glottic Webs. The Laryngoscope. 2021; 131(6): 1320-1323. doi:10.1002/lary.28965.
23. Gelbard A, Donovan DT, Ongkasuwan J, et al. Disease homogeneity and treatment heterogeneity in idiopathic subglottic stenosis. The Laryngoscope. 2016; 126(6): 1390-1396. doi:10.1002/lary.25708.
24. Yılmaz T. Endoscopic Z-plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients. The Laryngoscope. 2021; 131(2). doi:10.1002/lary.28787.
25. Davis RJ, Lina I, Motz K, et al. Endoscopic Resection and Mucosal Reconstitution With Epidermal Grafting: A Pilot Study in Idiopathic Subglottic Stenosis. Otolaryngol--head neck surg. 2022; 166(5): 917-926. doi:10.1177/01945998211028163.
26. Damrose EJ, Beswick DM. Repair of Posterior Glottic Stenosis with the Modified Endoscopic Postcricoid Advancement Flap. Otolaryngol--head neck surg. 2016; 154(3): 568-571. doi:10.1177/0194599815622626.
27. Aarnæs MT, Sandvik L, Brøndbo K. Idiopathic subglottic stenosis: an epidemiological single-center study. Eur Arch Otorhinolaryngol. 2017; 274(5): 2225-2228. doi:10.1007/s00405-017-4512-0.
28. Kraft SM, Sykes K, Palmer A, Schindler J. Using Pulmonary Function Data to Assess Outcomes in the Endoscopic Management of Subglottic Stenosis. Ann Otol Rhinol Laryngol. 2015; 124(2): 137-142. doi:10.1177/0003489414548915.
29. Gallagher L, Todatry S, Oldenburg K, Misono S, Gray R. Endoscopic treatment of subglottic stenosis with flexible bronchoscopy via laryngeal mask airway. The Laryngoscope. 2024; 134(6): 2672-2677. doi:10.1002/lary.31229.
30. Shoffel-Havakuk H, Lahav Y, Shopen Y, Reuven Y, Bachar G, Hamzany Y. Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis. The Laryngoscope. 2023; 133(4): 883-889. doi:10.1002/lary.30293.
31. Feinstein AJ, Goel A, Raghavan G, et al. Endoscopic Management of Subglottic Stenosis. JAMA Otolaryngol Head Neck Surg. 2017; 143(5): 500-505. doi:10.1001/jamaoto.2016.4131.
32. Rosen CA, Wang H, Cates DJ, Smith LJ. The glottis is not round: Teardrop-shaped glottic dilation for early posterior glottic stenosis. The Laryngoscope. 2019; 129(6): 1428-1432. doi:10.1002/lary.27594.
33. McCaffrey TV. Classification of laryngotracheal stenosis. Laryngoscope. 1992; 102(12 Pt 1): 1335-1340. doi:10.1288/00005537-199212000-00004.
2. Laryngeal Stenosis: Practice Essentials, Problem, Epidemiology. Published online November 28, 2023. Accessed June 4, 2024. https://emedicine.medscape.com/article/867177-overview#a1?form=fpf.
3. Anh TH, Anh TT, Duy PQ, Dung NTN. Khảo sát các phương pháp điều trị sẹo hẹp thanh - khí quản tại Bệnh viện Tai mũi họng TP Hồ Chí Minh. VMJ. 2023; 529(1). doi:10.51298/vmj.v529i1.6298.
4. Yamamoto K, Kojima F, Tomiyama K ichi, Nakamura T, Hayashino Y. Meta-Analysis of Therapeutic Procedures for Acquired Subglottic Stenosis in Adults. The Annals of Thoracic Surgery. 2011; 91(6): 1747-1753. doi:10.1016/j.athoracsur.2011.02.071.
5. Suzuki H, Tanifuji T, Hasegawa I, Fukunaga T. A forensic autopsy case of death from laryngeal stenosis due to a late complication of radiotherapy. Legal Medicine. 2016; 20: 15-17. doi:10.1016/j.legalmed.2016.03.004.
6. Nair S, Nilakantan A, Sood A, Gupta A, Gupta A. Challenges in the Management of Laryngeal Stenosis. Indian J Otolaryngol Head Neck Surg. 2016; 68(3): 294-299. doi:10.1007/s12070-015-0936-2.
7. Pan DR, Rosow DE. Office-based corticosteroid injections as adjuvant therapy for subglottic stenosis. Laryngoscope Investig Oto. 2019; 4(4): 414-419. doi:10.1002/lio2.284.
8. Lucioni M, Bertolin A, Lionello M, et al. Transoral laser microsurgery for managing laryngeal stenosis after reconstructive partial laryngectomies. The Laryngoscope. 2017; 127(2): 359-365. doi:10.1002/lary.26056.
9. Hseu AF, Benninger MS, Haffey TM, Lorenz R. Subglottic stenosis: A ten-year review of treatment outcomes. The Laryngoscope. 2014; 124(3): 736-741. doi:10.1002/lary.24410.
10. Zhao J, Li J, Guo H. A Novel Keel for Treatment of Anterior Glottic Webs. American Journal of Otolaryngology and Head and Neck Surgery. 2019; 2(9). Accessed June 28, 2025. https://www.remedypublications.com/american-journal-of-otolaryngology-and-head-and-neck-surgery-abstract.php?aid=5249.
11. Neevel AJ, Schuman AD, Morrison RJ, Hogikyan ND, Kupfer RA. Serial Intralesional Steroid Injection for Subglottic Stenosis: Systemic Side Effects and Impact on Surgery-Free Interval. OTO Open. 2021; 5(4): 2473974X211054842. doi:10.1177/2473974X211054842.
12. Jiam NT, Dwyer CD, Rosen CA. Awake Laser Laryngeal Stenosis Surgery. The Laryngoscope. 2021; 131(5): E1633-E1637. doi:10.1002/lary.29295.
13. Maldonado F, Loiselle A, DePew ZS, et al. Idiopathic subglottic stenosis: An evolving therapeutic algorithm: Idiopathic Subglottic Stenosis. The Laryngoscope. 2014; 124(2): 498-503. doi:10.1002/lary.24287.
14. Wehbi N, Gleadhill CME, Ahmadian D, Skirko JR, Yip HT. In-office serial intralesional steroid injection for subglottic stenosis: Case series of 14 patients with multiple etiologies. World J Otorhinolaryngol Head Neck Surg. 2024; 11(1): 17-22. doi:10.1002/wjo2.159.
15. Hoffman MR, Coughlin AR, Dailey SH. Serial office-based steroid injections for treatment of idiopathic subglottic stenosis. The Laryngoscope. 2017; 127(11): 2475-2481. doi:10.1002/lary.26682.
16. Franco RA, Husain I, Reder L, Paddle P. Awake serial intralesional steroid injections without surgery as a novel targeted treatment for idiopathic subglottic stenosis. The Laryngoscope. 2018; 128(3): 610-617. doi:10.1002/lary.26874.
17. Hoffman MR, Francis DO, Mai JP, Dailey SH. Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects. Ann Otol Rhinol Laryngol. 2020; 129(4): 361-368. doi:10.1177/0003489419889066.
18. Fijolek J, Wiatr E, Gawryluk D, et al. Intratracheal Dilation-injection Technique in the Treatment of Granulomatosis with Polyangiitis Patients with Subglottic Stenosis. J Rheumatol. 2016; 43(11): 2042-2048. doi:10.3899/jrheum.151355.
19. Shabani S, Hoffman MR, Brand WT, Dailey SH. Endoscopic Management of Idiopathic Subglottic Stenosis: Factors Affecting Inter-Dilation Interval. Ann Otol Rhinol Laryngol. 2017; 126(2): 96-102. doi:10.1177/0003489416675357.
20. Erlandsson A, Lundquist A, Olofsson K. Mapping quality of life after balloon dilatation in subglottic stenosis using Dyspnea index and Short Form Health Survey-36. Eur Arch Otorhinolaryngol. 2024; 281(7): 3701-3706. doi:10.1007/s00405-024-08667-0.
21. Wierzbicka M, Tokarski M, Puszczewicz M, Szyfter W. The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology. J Laryngol Otol. 2016; 130(7): 674-679. doi:10.1017/S0022215116001122.
22. Enver N, Ramaswamy A, Pitman MJ. How I Do It: A Novel Technique for Endoscopic Placement of Stent in Management of Anterior Glottic Webs. The Laryngoscope. 2021; 131(6): 1320-1323. doi:10.1002/lary.28965.
23. Gelbard A, Donovan DT, Ongkasuwan J, et al. Disease homogeneity and treatment heterogeneity in idiopathic subglottic stenosis. The Laryngoscope. 2016; 126(6): 1390-1396. doi:10.1002/lary.25708.
24. Yılmaz T. Endoscopic Z-plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients. The Laryngoscope. 2021; 131(2). doi:10.1002/lary.28787.
25. Davis RJ, Lina I, Motz K, et al. Endoscopic Resection and Mucosal Reconstitution With Epidermal Grafting: A Pilot Study in Idiopathic Subglottic Stenosis. Otolaryngol--head neck surg. 2022; 166(5): 917-926. doi:10.1177/01945998211028163.
26. Damrose EJ, Beswick DM. Repair of Posterior Glottic Stenosis with the Modified Endoscopic Postcricoid Advancement Flap. Otolaryngol--head neck surg. 2016; 154(3): 568-571. doi:10.1177/0194599815622626.
27. Aarnæs MT, Sandvik L, Brøndbo K. Idiopathic subglottic stenosis: an epidemiological single-center study. Eur Arch Otorhinolaryngol. 2017; 274(5): 2225-2228. doi:10.1007/s00405-017-4512-0.
28. Kraft SM, Sykes K, Palmer A, Schindler J. Using Pulmonary Function Data to Assess Outcomes in the Endoscopic Management of Subglottic Stenosis. Ann Otol Rhinol Laryngol. 2015; 124(2): 137-142. doi:10.1177/0003489414548915.
29. Gallagher L, Todatry S, Oldenburg K, Misono S, Gray R. Endoscopic treatment of subglottic stenosis with flexible bronchoscopy via laryngeal mask airway. The Laryngoscope. 2024; 134(6): 2672-2677. doi:10.1002/lary.31229.
30. Shoffel-Havakuk H, Lahav Y, Shopen Y, Reuven Y, Bachar G, Hamzany Y. Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis. The Laryngoscope. 2023; 133(4): 883-889. doi:10.1002/lary.30293.
31. Feinstein AJ, Goel A, Raghavan G, et al. Endoscopic Management of Subglottic Stenosis. JAMA Otolaryngol Head Neck Surg. 2017; 143(5): 500-505. doi:10.1001/jamaoto.2016.4131.
32. Rosen CA, Wang H, Cates DJ, Smith LJ. The glottis is not round: Teardrop-shaped glottic dilation for early posterior glottic stenosis. The Laryngoscope. 2019; 129(6): 1428-1432. doi:10.1002/lary.27594.
33. McCaffrey TV. Classification of laryngotracheal stenosis. Laryngoscope. 1992; 102(12 Pt 1): 1335-1340. doi:10.1288/00005537-199212000-00004.