Overview
Clinical Overview
Subglottic stenosis (SGS) is inflammatory or scar related narrowing of the airway immediately below the vocal cords.
Subglottic stenosis (SGS) is inflammatory or scar-related narrowing of the airway immediately below the vocal cords. The narrowed segment behaves like a fixed bottleneck: a patient may compensate at rest, then develop marked work of breathing when activity, secretions, or edema further reduce the available lumen. Iatrogenic injury after endotracheal intubation or tracheostomy is the most common cause. Biphasic stridor localizes the problem to a fixed central airway obstruction. Stridor at rest with retractions, fatigue, cyanosis, altered mental status, or a declining respiratory effort signals threatened airway failure. Keep the patient calm, call for emergency airway support, and prepare for definitive airway management; severe obstruction may require rigid bronchoscopy or tracheostomy.