Bronchial Mucosal Abnormalities in Idiopathic Subglottic Stenosis.

OBJECTIVES

Investigate synchronous lower airway findings during bronchoscopy in idiopathic subglottic stenosis (iSGS).

METHODS

Retrospective analysis of bronchoscopic images from adult iSGS patients (January 2018-June 2021). Images were reviewed for pits, depressions, nodules, and striations distal to the cricotracheal junction.

RESULTS

Forty-eight female patients; mean age 56 years. Comorbidities: gastroesophageal reflux 34%, hypertension 34%, diabetes mellitus 25%. All patients had pits and depressions; striations in 48/48, with both longitudinal and transverse in 32/48 (66.7%), transverse only in 13/48 (27.1%), and longitudinal only in 3/48 (6.3%). Spirometry available in 32; 60% showed normal or mild-moderate fixed obstruction. Four patients had FEV1/FVC < 0.7; two had asthma, one COPD, and one no obstructive diagnosis; none were smokers.

CONCLUSION

Bronchial mucosal abnormalities are prevalent in iSGS and may indicate distal airway involvement. Routine flexible bronchoscopy should be considered during evaluation and surveillance.