Life-threatening idiopathic subglottic stenosis misdiagnosed as asthma

Dreyer, Niloofar Sherazi; Gregersen, Kristine Grubbe; Bork, Kristian Hveysel

doi:10.1080/23772484.2022.2050374

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Subglottic stenosis (SGS) refers to a pathological narrowing of the trachea near the larynx. SGS can be of idiopathic, congenital, or acquired origin (e.g., as a result of prolonged intubation) [1]. Apart from common symptoms like hoarse voice, shortness of breath, and dysphonia, SGS can also lead to adventitious tonal sound during respiration, which is sometimes referred to as stridor [1][2][3][4].…”

Section: Introduction 1subglottic Stenosis and Respiratory Soundsmentioning

confidence: 99%

“…SGS can be of idiopathic, congenital, or acquired origin (e.g., as a result of prolonged intubation) [1]. Apart from common symptoms like hoarse voice, shortness of breath, and dysphonia, SGS can also lead to adventitious tonal sound during respiration, which is sometimes referred to as stridor [1][2][3][4]. For example, P. H. Holinger et al [4] reported that in infants and children with congenital SGS, 43% presented stridor.…”

Section: Introduction 1subglottic Stenosis and Respiratory Soundsmentioning

confidence: 99%

“…Due to the subjective nature of human perception [7] and the variability in the characteristics of stridor and other respiratory sounds, patients with SGS and stridor are sometimes misdiagnosed with other conditions like asthma and pneumonia. Such a misdiagnosis can be life-threatening [1,8,9].…”

Section: Introduction 1subglottic Stenosis and Respiratory Soundsmentioning

confidence: 99%

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Effect of Subglottic Stenosis on Expiratory Sound Using Direct Noise Calculation

Geng,

Xue,

Thomson

et al. 2023

Applied Sciences

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Subglottic stenosis (SGS) is a rare yet potentially life-threatening condition that requires prompt identification and treatment. One of the primary symptoms of SGS is a respiratory sound that is tonal. To better understand the effect of SGS on expiratory sound, we used direct noise calculation to simulate sound production in a simplified axisymmetric configuration that included the trachea, the vocal folds, the supraglottal tract, and an open environmental space. This study focused on flow-sustained tones and explored the impact of various parameters, such as the SGS severity, the SGS distance, the flowrate, and the glottal opening size. It was found that the sound pressure level (SPL) of the expiratory sound increased with flowrate. SGS had little effect on the sound until its severity approached 75% and SPL increased rapidly as the severity approached 100%. The results also revealed that the tonal components of the sound predominantly came from hole tones and tract harmonics and their coupling. The spectra of the sound were greatly influenced by constricting the glottis, which suggests that respiratory tasks that involve maneuvers to change the glottal opening size could be useful in gathering more information on respiratory sound to aid in the diagnosis of subglottic stenosis.

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Section: Introduction 1subglottic Stenosis and Respiratory Soundsmentioning

confidence: 99%

Section: Introduction 1subglottic Stenosis and Respiratory Soundsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Subglottic Stenosis on Expiratory Sound Using Direct Noise Calculation

Geng,

Xue,

Thomson

et al. 2023

Applied Sciences

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Differentiating asthma and tracheal stenosis: why confirmation of the diagnosis of asthma should precede treatment

Kazi,

Shidid,

Gutierrez

et al. 2024

Journal of Asthma

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Unmasking Subglottic Stenosis in an Asthmatic Emergency Needing Front-of-Neck Access: A Case Report

Leong,

Tay,

Chua

2024

Cureus

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Subglottic stenosis poses a rare but life-threatening risk for difficult tracheal intubation. Here, we report a unique case of undiagnosed subglottic stenosis discovered during emergency intubation of an 80-year-old woman with type 2 respiratory failure from infective exacerbation of asthma. A small calibre size 5.0 tracheal tube was successfully inserted, but significant difficulties with mechanical ventilation, nebulizations, and secretion management necessitated front-of-neck access with a surgical tracheostomy. Drawing on our experience of this case, we consider the diagnostic and management challenges of subglottic stenosis and discuss the issues of mechanical ventilation through small calibre tubes in patients with severe bronchospasm.

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Life-threatening idiopathic subglottic stenosis misdiagnosed as asthma

Cited by 3 publications

References 7 publications

Effect of Subglottic Stenosis on Expiratory Sound Using Direct Noise Calculation

Effect of Subglottic Stenosis on Expiratory Sound Using Direct Noise Calculation

Differentiating asthma and tracheal stenosis: why confirmation of the diagnosis of asthma should precede treatment

Unmasking Subglottic Stenosis in an Asthmatic Emergency Needing Front-of-Neck Access: A Case Report

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