Subglottic stenosis masquerading as asthma in a young adult: an overlooked and delayed diagnosis

An otherwise fit young woman presented with a 10-year history of non-progressive wheeze and 'noisy breathing'. She had previously been diagnosed with teenage-onset asthma but had been unresponsive to inhaled corticosteroids and bronchodilators. A dysfunctional breathing disorder had been considered a possible diagnosis by several general practitioners, and there were no features to suggest systemic conditions. The patient had undergone an otherwise apparently uncomplicated intubation general anaesthetic for a gastroenterological investigation 13 years earlier. An outpatient flexible endoscopic examination of the upper aerodigestive tract demonstrated an isolated subglottic stenosis which was characterised by cross-sectional imaging. Microlaryngoscopy confirmed a smooth subglottic stenosis which was dilated using a minimally invasive balloon dilatation technique to good clinical effect.