Various factors can have an effect on the clinical presentation of a patient affected by laryngeal stenosis. It is known that medical history, age, length of the stenosed segment, and general physical condition all influence the final symptomatology.

The most frequent manifestation associated with laryngeal stenosis is stridor, a high-pitched, wheezing sound heard during inhalation or inhalation/ exhalation (biphasic stridor) [1]. The former stridor type is mostly linked to a stenosed glottic or supraglottic region.Stridor is heard when the stenosis has reached approximately 50% of the laryngeal diameter, at which time dyspnea also complicates the clinical picture [2] [3]. Milder narrowing could be marked by a progressively worsening cough. Patients suffering from laryngeal stenosis at the glottic level may also display a hoarse voice, aphonia, dysphagia, hypoxia, cyanosis, and anxiety.

In pediatric patients, laryngeal stenosis may cause no respiratory symptoms at an early stage, but poor appetite and delayed growth may be reported. Recurrent croup is a common finding amongst children affected by laryngeal stenosis of the subglottic area. Congenital laryngeal narrowing tends to present with less alarming symptoms than an acquired stenosis. In addition, children who present with laryngeal stenosis may also have a history of tracheotomy or laryngotracheal reconstruction.

In some cases, the presenting manifestation of laryngeal restriction is severe dyspnea associated with an individual who reports an aggravation of the symptoms following a decannulation/extubation [4].

• Hoarseness

  The cardiovascular cause of the hoarseness might be of much higher consequence for the patient as the hoarseness itself, as in the presented case. [hindawi.com]

  Laryngeal stenosis implies a narrowing of the larynx, whether at the supraglottic, glottic, or subglottic level, which may lead to obstructed breathing, dyspnea, and hoarseness. [voiceindy.com]

  Other problems that affect the throat include Tonsillitis - inflammation of the tonsils Cancer Croup - inflammation, usually in small children, which causes a barking cough Laryngitis - swelling of the voice box, which can cause a hoarse voice or loss [icdlist.com]

  TABLE 90.1 SIGNS AND SYMPTOMS OF LARYNGEAL STENOSIS Laryngeal Region Signs and Symptoms Subglottis Hoarse or normal voice, biphasic stridor, normal feeding (except with severe obstruction), barking cough Glottis Hoarse voice or aphonia, inspiratory (early [entokey.com]

  Patients suffering from laryngeal stenosis at the glottic level may also display a hoarse voice, aphonia, dysphagia, hypoxia, cyanosis, and anxiety. [symptoma.com]

• Laryngeal Disease

  Respiratory Tract Diseases Laryngeal Diseases Otorhinolaryngologic Diseases Respiratory System Abnormalities Congenital Abnormalities Mitomycins Mitomycin Antibiotics, Antineoplastic Antineoplastic Agents Alkylating Agents Molecular Mechanisms of Pharmacological [clinicaltrials.gov]

• Low Set Ears

  Individuals with deletions in this region have growth retardation, psychomotor retardation, micrognathia, microcephaly, and apparently low-set ears. [ncbi.nlm.nih.gov]

• Long Arm

  Deletions of the long arm of chromosome 2 are rare. Few cases of interstitial deletions of the 2q33q35 region have been reported. [ncbi.nlm.nih.gov]

• Depressed Nasal Bridge

  nasal bridge and midface hypoplasia. [ncbi.nlm.nih.gov]

• Psychomotor Retardation

  Individuals with deletions in this region have growth retardation, psychomotor retardation, micrognathia, microcephaly, and apparently low-set ears. [ncbi.nlm.nih.gov]

Manifestations that indicate difficulty in breathing and subsequent oxygenation, such as stridor, cyanosis, and cough should always raise suspicion of laryngeal stenosis. A medical history of intubation or tracheostomy also suggests the possibility of this specific pathology and should be investigated.

With reference to laboratory tests, laryngeal stenosis is normally not diagnosed via blood tests. However, underlying conditions that may predispose the patient to this type of the disorder can be evaluated, such as Wegener's granulomatosis, sarcoidosis, or rheumatoid arthritis. Blood gas analysis can reveal hypoxia in severe cases.

The diagnosis of laryngeal stenosis can be achieved through a multitude of imaging modalities. Plain lateral and anteroposterior neck radiographs can illustrate airway diameter and the extent of the narrowed segment, as well as possible contributing or causing disorders, such as epiglottitis and a retropharyngeal abscess. Thoracic X-ray helps to depict concurrent pathologies of the thorax. The larynx can be evaluated, without the need for general anesthesia, down to the glottic level via flexible fiberoptic endoscopy. Nevertheless, bronchoscopy and direct laryngoscopy constitute the gold standard for the diagnosis [5].

A computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan are usually not the first-line tools of assessment but can be utilized in the detailed evaluation. The MRI scan precisely illustrates regional vascular anatomy [6].

Laryngeal electromyography and pulmonary function tests can also be employed in the workup procedure [7].

The method of treatment, and the advantages and disadvantages of the new method of endoscopic treatment of postintubation laryngeal stenosis, are discussed in the article. [ncbi.nlm.nih.gov]

The long-term prognosis for most children is very good, and the successes are emotionally rewarding. [ncbi.nlm.nih.gov]

The prognosis depends on the underlying disease causing the stenosis. With regard to laryngeal function is often not favorable, some patients can be surgically partially restore them. With this material are reading... My Great Web page Attachments: [eurodoctor.ucoz.com]

In children with postintubation laryngeal stenosis we frequently find other coexisting general diseases, which have an effect on treatment and on the prognosis in relation to the health of the child. Piśmiennictwo 1. [czytelniamedyczna.pl]

Prognosis of this syndrome depends on the underlying cardiovascular condition and correction of the underlying cardiac or vascular anomaly is important to a successful recovery. [hindawi.com]

OUTCOME AND PROGNOSIS The outcome of laryngotracheal reconstruction depends on its grade and the procedure performed. [tracheostomy.com]

We studied the influence of various factors on the final outcome including age, sex, etiology, associated conditions, length and diameter of the stenotic segment, as well as its anatomic site. [ncbi.nlm.nih.gov]

The objective of this paper is to study the etiology, age distribution, sex, associated pathologies, location and degree of the laryngeal stenosis. [arquivosdeorl.org.br]

We present a case report of Ortner’s syndrome of uncommon etiology that illustrates the underlying pathoanatomical mechanisms. 2. [hindawi.com]

[Modern views on etiology, pathogenesis, clinical picture, diagnosis and treatment of laryngeal papillomatosis]. Vestnik otorino¬laringologii. 2000;1:44-49. Russian. Soldatskiy YL, Onufriyeva EK, Schepin NV. et al. [journals.uran.ua]

Pathophysiological mechanism of this syndrome is thought to be compression of the left recurrent laryngeal nerve between the aorta and dilated pulmonary artery [ 12 ], and this can be well appreciated from the axial CT images and coronal and sagittal [hindawi.com]

Pathophysiology: Acquired SGS often is caused by endotracheal intubation. [tracheostomy.com]

ALERTA BUBBLE OVERLAY DECUBITUS PREVENTION SYSTEM 17.09.2018 Alerta Bubble – a light-weight and compact overlay alternating pressure relieving mattress system for effective prevention and treatment of patients at low risk of developing a pressure ulcer [medica-tradefair.com]

The keel also has application following hemilaryngectomy to prevent stenosis. The intralaryngeal extension of the keel is thinner than the umbrella of the extralaryngeal portion. [bosmed.com]

Case Reports: Four patients, three males and one female, sought expert service with history of ingestion of caustic soda, preventing dyspnea. Tracheostomy was necessary in the female patient. [thieme-connect.com]

What can be done to prevent diseases of the larynx? Quitting smoking and cutting back on drinking alcohol can help prevent laryngeal cancer. [my.clevelandclinic.org]

The graft is made to be elliptical in shape, and is beveled at the edges (to prevent setting into the lumen). It is positioned and secured into place with the perichondrium surface facing the lumen. [childrensenthouston.com]

1. Bluestone C, Stool S, Kenna M. Pediatric Otolaryngology. 3rd ed. Philadelphia, PA: WB Saunders Co; 1995. 1275-1286.
2. Sue RD, Susanto I. Long-term complications of artificial airways. Clin Chest Med. 2003;24(3):457–471.
3. Nair S, Mohan S, Mandal G, Nilakantan A. Tracheal Stenosis: Our Experience at a Tertiary Care Centre in India with Special Regard to Cause and Management. Indian J Otolaryngol Head Neck Surg. 2014; 66(1): 51–56.
4. Brichet A, Verkindre C, Dupont J, et al. Multidisciplinary approach to management of postintubation tracheal stenoses. Eur Respir J. 1999;13(4):888–893.
5. Antón-Pacheco JL, Cano I, García A, et al. Patterns of management of congenital tracheal stenosis. J Pediatr Surg 2003;38:1452-1458.
6. Schweiger C, Cohen AP, Rutter MJ. Tracheal and bronchial stenoses and other obstructive conditions. J Thorac Dis. 2016; 8(11): 3369–3378.
7. Boemo RL, Navarrete ML, Genestar EI, Gonzalez M, Fuentes JF, Fortuny P. Interarytenoid osseous bridge after prolonged endotracheal intubation. Acta Otorrinolaringol Esp. 2012;63(6):480-481.