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Bronchial Mucosal Abnormalities in Idiopathic Subglottic Stenosis
Sydney Ring1, Andrew Jay Bowen2, Tessa Griffin3,4
1Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
The Laryngoscope
|April 12, 2026
Summary
Bronchial mucosal abnormalities are common in idiopathic subglottic stenosis (iSGS). Flexible bronchoscopy during evaluation can reveal these lower airway findings, aiding diagnosis and surveillance.
Area of Science:
- Pulmonology
- Otolaryngology
- Respiratory Medicine
Background:
- Idiopathic subglottic stenosis (iSGS) is a rare condition affecting the airway below the cricoid cartilage.
- The extent of lower airway involvement in iSGS is not well-characterized.
Purpose of the Study:
- To investigate synchronous lower airway findings during bronchoscopy in adult patients with iSGS.
- To identify the prevalence and types of bronchial mucosal abnormalities in iSGS.
Main Methods:
- Retrospective analysis of bronchoscopic images from 48 adult iSGS patients (January 2018-June 2021).
- Review of images for specific findings: pits, depressions, nodules, and striations distal to the cricotracheal junction.
- Correlation with available spirometry data.
Main Results:
- All 48 patients exhibited pits and depressions in the lower airway.
- Striations were present in all patients, with combined longitudinal and transverse patterns in 66.7%.
- Spirometry in 32 patients revealed normal or mild-moderate fixed obstruction in 60%.
Conclusions:
- Bronchial mucosal abnormalities are highly prevalent in iSGS patients.
- These findings suggest potential distal airway involvement and support routine flexible bronchoscopy for evaluation and surveillance.
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