Review of adult laryngotracheal stenosis: pathogenesis, management, and outcomes.

PURPOSE OF REVIEW: Adult laryngotracheal stenosis (LTS) is a potentially life-threatening disorder that can be difficult to diagnose and treat. Much is unknown regarding the etiology of airway stenosis, and while many patients do well with standard surgical management, the recurrence rate is significant. Few medical therapies exist, but there is a growing need.

RECENT FINDINGS: Several basic science studies have shown a role of inflammatory signaling pathways in the development of LTS. Infectious processes may also play a role in development of stenosis, while treatment with anti-inflammatory and immunosuppressive medications has shown some promise in preventing disease. Several risk factors, such as diabetes, BMI, length of stenosis, and need for T-tube, have been identified that portend worse surgical outcomes and may assist physicians in choosing appropriate treatment.

SUMMARY: While adult LTS is a complex, challenging clinical entity, there is promising research into the inflammatory origins of the disorder, which may open up groundbreaking new avenues of medical treatment.