Isolated adult supraglottic stenosis: surgical treatment and possible etiologies

Isolated supraglottic stenosis in adults without a history of laryngeal injury is a rare and poorly described clinical entity. We report a case of a 61-year-old woman who presented with near total airway obstruction and a diagnosis of an epiglottic mass. She required a tracheotomy for definitive airway control. Initial diagnostic laryngoscopy and biopsies revealed isolated supraglottic stenosis due to fibrosis with acute and chronic inflammation. The patient had a medical history of gastroesophageal reflux disease and hiatal hernia and no history of laryngeal trauma. Transoral supraglottic laryngectomy was required for definitive treatment. Isolated supraglottic stenosis may be seen in children with congenital laryngotracheal anomalies, as a sequelae of prolonged orotracheal intubation or after laryngeal trauma or tumor surgery. Other causes may include autoimmune and inflammatory disorders. Gastroesophageal reflux disease may also contribute to the disease process of isolated supraglottic stenosis. Supraglottic laryngectomy is a feasible treatment option for isolated supraglottic stenosis and may allow for tracheostomy decannulation.