Subglottische Pathologien

Zusammenfassung

Subglottische Pathologien sind sehr selten und manifestieren sich mit einem unspezifischen klinischen Erscheinungsbild in Form einer Gewebevermehrung auf Höhe des Ringknorpels bzw. der cranialen Trachea, was die Diagnose verschleiert. Typische Symptome solcher Patienten sind Heiserkeit, Reizhusten, ein Fremdkörpergefühl sowie Dyspnoe bzw. Stridor. Differenzialdiagnostisch kommen verschiedene Erkrankungen in Frage: Benigne Erkrankungen wie Folgen eines Traumas (z. B. Stenosen), Entzündungen (z. B. Pseudokrupp), rheumatische Erkrankungen (z. B. Granulomatose mit Polyangiitis) oder gutartige Tumore (z. B. Papillom, Hämangiom oder Granularzelltumor). Auch maligne Erkrankungen wie z. B. ein Plattenepithelkarzinom des Larynx, ein Chondrosarkom oder sehr selten eine laryngeale Lymphommanifestation müssen differenzialdiagnostisch in Erwägung gezogen werden. Idiopathische Formen ohne erkennbare Ursache sind ebenfalls denkbar. Zur Diagnosesicherung wird bei tumorösen Veränderungen in der Regel eine Probeexzision mit histologischer Aufarbeitung durchgeführt. Die Therapie erfolgt in Abhängigkeit vom histologischen Ergebnis – bei soliden tumorösen Erkrankungen üblicherweise chirurgisch oder durch eine Lokal- bzw. Systemtherapie im interdisziplinären Kontext.

Abstract

Subglottic pathologies are rare and show a clinical unspecific appearance i. e. through tissue increase around the cricoid or the cranial trachea. Typical symptoms are hoarseness, an overstimulated coughing, a globus laryngeus feeling as well as dyspnea or a stridor. Differential diagnosis include benign diseases like involving a posttraumatic status (e. g. stenosis), infection (i. e. pseudocroup), rheumatic disease (i. e. granulomatosis with polyangiitis) or benign tumor (i. e. papilloma, hemangioma or granular cell tumor). On the other hand, malignant diseases like the squamous cell carcinoma, a chondrosarcoma or the very rare laryngeal lymphoma manifestation must be considered as well. Idiopathic causes should also be taken into account. To secure the final diagnosis of such tumor formation a tissue sample should be histologically analyzed. The therapy is multimodal e. g. in close collaboration with internal medicine and ENT specialists.

Schlüsselwörter

Subglottische Stenosen - subglottische Zysten - entzündliche subglottische Stenosen - autoimmunologische subglottische Stenosen - benigne subglottische Tumore - maligne subglottische Tumore

Key words

Subglottic stenosis - subglottic cysts - autoimmunological subglottic stenosis - benign subglottic tumors - malignant subglottic tumors - inflammatory subglottic stenosis

• Literatur

• 1 Wittekind C. Union for international cancer control (UICC): TNM Klassifikation maligner Tumoren. 2017. 8. Auflage. Wiley-VCH;
• 2 Mor N, Blitzer A. Functional Anatomy and Oncologic Barriers of the Larynx. Otolaryngol Clin North Am 2015; 48 (04) 533-45
• 3 Smith MM, Cotton RT. Diagnosis and management of laryngotracheal stenosis. Expert Rev Respir Med 2018; 12 (08) 709-717
• 4 Jefferson ND, Cohen AP, Rutter MJ. Subglottic stenosis. Semin Pediatr Surg 2016; 25 (03) 138-43
• 5 Sittel C. Pathologies of the larynx an trachea in childhood. GMS Curr Top Otorhinolaryngol Head Neck Surg 2014; 13: Doc09 doi: 10.3205/cto000112. eCollection 2014
• 6 Ebert B, Sidman J, Morrell N. et al. Congenital and iatrogenic laryngeal and vocal abnormalities in patients with 22q11.2 deletion. Int J Pediatr Otorhinolaryngol 2018; 109: 17-20
• 7 Shott SR. Down syndrome: analysis of airway size and a guide for appropriate intubation. Laryngoscope 2000; 110 (04) 585-92
• 8 Blanchard M, Leboulanger N, Thierry B. et al. Management specificities of congenital laryngeal stenosis: external and endoscopic approaches. Laryngoscope 2014; 124 (04) 1013-8
• 9 Lewis S, Earley M, Rosenfeld R. et al. Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis. Laryngoscope 2017; 127 (01) 191-198
• 10 Kim SS, Khalpey Z, Hsu C. et al. Changes in Tracheostomy- and Intubation-Related Tracheal Stenosis: Implications for Surgery. Ann Thorac Surg 2017; 104 (03) 964-970
• 11 Yamamoto K, Jaquet Y, Ikonomidis C. et al. Partial cricotracheal resection for paediatric subglottic stenosis: update of the Lausanne experience with 129 cases. Eur J Cardiothorac Surg 2015; 47 (05) 876-82
• 12 Avelino M, Maunsell R, Jubé I Wastowski. Predicting outcomes of balloon laryngoplasty in children with subglottic stenosis. Int J Pediatr Otorhinolaryngol 2015; 79 (04) 532-6
• 13 Nicolli EA, Carey RM, Farquhar D. et al. Risk factors for adult acquired subglottic stenosis. J Laryngol Otol 2017; 131 (03) 264-267
• 14 Monnier P, Dikkers FG, Eckel H. et al. Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European Laryngological Society. Eur Arch Otorhinolaryngol 2015; 272 (10) 2885-96
• 15 Aksoy EA, Elsürer C, Serin GM. et al. Evaluation of pediatric subglottic cysts. Int J Pediatr Otorhinolaryngol 2012; 76 (02) 240-3
• 16 Rodrigues AJ, Cardoso SR, Cereda DC. et al. Subglottic cyst: a rare cause of laryngeal stridor. J Bras Pneumol 2012; 38 (01) 138-9
• 17 Sobol SE, Zapata S. Epiglottitis and croup. Otolaryngol Clin North Am 2008; 41 (03) 551-66
• 18 Sittel C. Idiopathic progressive subglottic stenosis. Laryngorhinootologie 2014; 93 (07) 474-81
• 19 Tibballs J, Watson T. Symptoms and signs differentiating croup and epiglottitis. J Paediatr Child Health 2011; 47 (03) 77-82
• 20 Pickhard A, Smith E, Rottscholl R. et al. Disorders of the larynx and chronic inflammatory diseases. Laryngorhinootologie 2012; 91: 758-66
• 21 Reiter R, Brosch S, Smith E. et al. Manifestation of rheumatic diseases in the larynx]. Laryngorhinootologie 2015; 94 (03) 189-95 quiz 196–8
• 22 Gottschlich S, Ambrosch P, Kramkowski D. et al. Head and neck manifestations of Wegener’s granulomatosis. Rhinology 2006; 44 (04) 227-33
• 23 Teitel AD, MacKenzie CR, Stern R. et al. Laryngeal involvement in systemic lupus erythematosus. Semin Arthritis Rheum 1992; 22 (03) 203-14
• 24 Mrówka-Kata K, Kata D, Lange D. et al. Sarcoidosis and its otolaryngological implications. Eur Arch Otorhinolaryngol 2010; 267 (10) 1507-14
• 25 Peters JE, Salama AD, Ind PW. Wegener’s granulomatosis presenting as acute systemic vasculitis following 20 years of limited tracheobronchial disease. J Laryngol Otol 2009; 23 (12) 1375-7
• 26 Belostotsky VM, Shah V, Dillon MJ. Clinical features in 17 paediatric patients with Wegener granulomatosis. Pediatr Nephrol 2002; 17 (09) 754-61
• 27 Gluth MB, Shinners PA, Kasperbauer JL. Subglottic stenosis associated with Wegener’s granulomatosis. Laryngoscope 2003; 113 (08) 1304-7
• 28 Wittekindt C, Lüers JC, Drebber U. et al. ANCA-negative subglottic laryngeal stenosis in childhood. HNO 2007; 55 (10) 807-11
• 29 Blaivas AJ, Strauss W, Yudd M. Subglottic stenosis as a complication of Wegener’s granulomatosis. Prim Care Respir J 2008; 17 (02) 114-6
• 30 Herold G. Innere Medizin. Köln: 2011: S 1-576
• 31 Reiter R, Brosch S, Rottscholl R. et al. Dysphonia as a symptom of an amyloidosis. Laryngorhinootologie 2013; 92 (08) 2013 Aug; 92 (8): 541-2
• 32 Gallivan GJ, Gallivan HK. Laryngeal amyloidosis causing hoarseness and airway obstruction. J Voice 2010; 24 (02) 235-9
• 33 Penner CR, Muller S. Head and neck amyloidosis: a clinicopathologic study of 15 cases. Oral Oncol 2006; 42 (04) 421-9
• 34 Reiter R, Ruess J, Brosch S. et al. {Refractory Hoarseness In Granular Cell Tumor of the Vocal Cord]. Laryngorhinootologie 2016; 95 (02) 125-6
• 35 Arevalo C, Maly B, Eliashar R. et al. Laryngeal granular cell tumor. J Voice 2008; 22 (03) 339-42
• 36 McIntyre CJ, Allen JL, Powell H. et al. Novel surgical management of a laryngeal granular cell tumour. BMJ Case Rep. 2015
• 37 Venkatesan NN, Pine HS, Underbrink MP. Recurrent respiratory papillomatosis. Otolaryngol Clin North Am 2012; 45 (03) 671-94
• 38 Malagón T, Drolet M, Boily MC. et al. Cross protective afficacy of two human papillomavirus vaccines: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12: 781-9
• 39 Derkay CS, Wiatrak B. Recurrent respiratory papillomatosis: a review. Laryngoscope 2008; 118: 1236-47
• 40 Silva L, Gonçalves CP, Fernandes AM. et al. Laryngeal papillomatosis in children: The impact of late recognition over evolution. J Med Virol 2015; 87 (08) 1413-7
• 41 Schwartz T, Faria J, Pawar S. et al. Efficacy and rebound rates in propranolol-treated subglottic hemangioma: A literature review. Laryngoscope 2017; 127 (11) 2665-2672
• 42 Ting M, Roseby R, McAdam C. Subglottic infantile haemangioma: A rare but important consideration in young infants presenting with stridor. J Paediatr Child Health 2016; 52 (12) 1111-1113
• 43 Darrow DH. Management of Infantile Hemangiomas of the Airway. Otolaryngol Clin North Am 2018; 51 (01) 133-146
• 44 Ahmad I, Kirby P, Liming B. Ecopic Thymic Cyst of the Subglottis: Considerations for Diagnosis and Management. Ann Otol Rhinol Laryngol 2018; 127 (03) 200-204
• 45 Deng S, Liu T, Liu J. et al. [Subglottic schwannoma misdiagnosed as bronchial asthma in one case]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50 (06) 511
• 46 Hope N, Smith CP, McCluney N. Angioleiomyoma of the larynx: beware the subglottic lesion. BMJ Case Rep. 2015
• 47 Zatoński T, Bolanowski M, Jędrzejuk D. et al. Intralaryngeal ectopic thyroid. Otolaryngol Pol 2014; 68 (01) 46-9
• 48 Kurien R, Michael R. Subglottic thyroglossal duct cyst: a rare intralaryngeal presentation. Ear Nose Throat J 2012; 91 (07) E15-9
• 49 Gamalski S, Munoz J, Diaz-Kuan A. et al. Germ cell tumour of the trachea. BMJ Case Rep. 2012 2012.
• 50 Nouraei SA, Sandhu GS. Outcome of a multimodality approach to the management of idiopathic subglottic stenosis. Laryngoscope 2013; 123 (10) 2474-84
• 51 Blumin JH, Johnston N. Evidence of extraesophageal reflux in idiopathic subglottic stenosis. Laryngoscope 2011; 121 (06) 1266-73
• 52 Aarnæs MT, Sandvik L, Brøndbo K. Idiopathic subglottic stenosis: an epidemiological single-center study. Eur Arch Otorhinolaryngol 2017; 274 (05) 2225-2228
• 53 Fiz I, Bittar Z, Piazza C. et al. Hormone receptors analysis in idiopathic progressive subglottic stenosis. Laryngoscope 2018; 128 (02) E72-E77
• 54 Pearson FG. Idiopathic laryngotracheal stenosis. J Thorac Cardiovasc Surg 2004; 127 (01) 10-1
• 55 Ashiku SK, Kuzucu A, Grillo HC. et al. Idiopathic laryngotracheal stenosis: effective definitive treatment with laryngotracheal resection. J Thorac Cardiovasc Surg 2004; 127 (01) 99-107
• 56 Sittel C, Blum S, Streckfuss A. et al. Cricotracheal resection in nontracheotomized adults: a prospective case series. Ann Otol Rhinol Laryngol 2008; 117 (04) 288-94
• 57 Ferlay J, Shin HR, Bray F. et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 15; 127 (12) 2893-2917
• 58 Robert Koch Institut, Zentrum für Krebsregisterdaten, Krebs in Deutschland 2007/2008, 8. Ausgabe. 2012 S. 12–13 und 52–55
• 59 Marchiano E, Chin OY, Fang CH. et al. Laryngeal Adenoid Cystic Carcinoma: A Systematic Review. Otolaryngol Head Neck Surg 2016; 154 (03) 433-9
• 60 Garas J, McGuirt Sr WF. Squamous cell carcinoma of the subglottis. Am J Otolaryngol 2006; 27 (01) 1-4
• 61 Smee RI, Williams JR, Bridger GP. The management dilemmas of invasive subglottic carcinoma. Clin Oncol (R Coll Radiol) 2008; 20 (10) 751-6
• 62 Pantel M, Guntinas-Lichius O. Larynxkarzinom: Epidemiologie, Risikofaktoren und 8 Uberleben. [Laryngeal carcinoma: epidemiology, risk factors and survival]. HNO 2012; 60 (01) 9 p. 32-40
• 63 Leemans CR, Braakhuis BJ, Brakenhoff RH. The molecular biology of head and neck cancer. Nat Rev Cancer 2011; 11 (01) 9-22
• 64 Ulusan M, Yilmazer R, Ozluk Y. et al. Radiation-induced osteosarcoma of the larynx: case report and literature review. Ear Nose Throat J 2012; 91 (10) E22-5 Review
• 65 Coskun H, Mendenhall WM, Rinaldo A. et al. Prognosis of subglottic carcinoma: Is it really worse?. Head Neck. 2018
• 66 Arens C. Transoral treatment strategies in head and neck tumors. Laryngorhinootologie 2012; 91 (Suppl. 01) 86-101
• 67 Chera BS, Amdur RJ, Morris CG. et al. T1N0 to T2N0 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy. Int J Radiat Oncol Biol Phys 2010; 78 (02) 461-6
• 68 Varela P, Pio L, Brandigi E. et al. Tracheal and bronchial tumors. J Thorac Dis 2016; 8 (12) 3781-3786
• 69 Kashiwagi T, Kanaya H, Konno W. et al. Adenoid cystic carcinoma of the larynx presenting with unusual subglottic mass: Case report. Auris Nasus Larynx 2016; 43 (05) 562-5
• 70 Karatayli-Ozgursoy S, Bishop JA, Hillel AT. et al. Malignant salivary gland tumours of the larynx: a single institution review. Acta Otorhinolaryngol Ital 2016; 36 (04) 289-294
• 71 Aydin O, Ustündağ E, Işeri M. et al. Laryngeal adenoid cystic carcinoma in an adolescent. Kulak Burun Bogaz Ihtis Derg 2008; 18 (05) 319-22
• 72 Dubal PM, Svider PF, Folbe AJ. et al. Laryngeal adenoid cystic carcinoma: A population-based perspective. Laryngoscope 2015; 125 (11) 2485-90
• 73 Sauter A, Bersch C, Lambert KL. et al. Chondrosarcoma of the larynx and review of the literature. Anticancer Res 2007; 27 (4 C): 2925-9
• 74 Kökoğlu K, Canöz O, Doğan S. et al. Laryngeal chondrosarcoma as a rare cause of subglottic stenosis. Case Rep Otolaryngol 2014; 2014: 730643
• 75 Reiter R, Rettinger G, Veit J. et al. [Chondrosarcoma of the larynx in patient with vocal fold augmentation with teflon]. Laryngorhinootologie 2012; 91 (10) 644-5
• 76 Jain A, Singh SN, Singhal P. et al. A rare case of subglottic embryonal rhabdomyosarcoma: managed with the aim of organ preservation. J Laryngol Otol 2015; 129 (01) 106-9
• 77 Anithakumari AM, Somashekhar SP, Mondal SK. Neurofibrosarcoma of the Subglottis-A Rare Case Report. Indian J Surg Oncol 2015; 6 (02) 113-5
• 78 Hammas N, Benmansour N, El Alami El Amine MN. et al. Lymphoepithelial carcinoma: a case report of a rare tumor of the larynx. BMC Clin Pathol 2017; 17: 24
• 79 Singh H, Chauhan A. Primary small cell carcinoma of the larynx: report of a rare tumor. Case Rep Oncol Med 2011; 2011: 978676
• 80 Zaghi S, Pouldar D, Lai C. et al. Subglottic presentation of a rare tumor: primary or metastatic? Primary mucosal melanoma of the subglottic larynx. JAMA Otolaryngol Head Neck Surg. 2013
• 81 Ferlito A, Caruso G, Recher G. Secondary laryngeal tumors. Report of seven cases with review of the literature. Arch Otolaryngol Head Neck Surg 1988; 114 (06) 635-9
• 82 Heyes R, Balakumar R, Ramdoo K. et al. Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome. Case Rep Otolaryngol 2017; 2017: 2131068
• 83 Ta JQ, Kim JY. Rectal adenocarcinoma metastatic to the larynx. Ear Nose Throat J 2011; 90 (04) E28
• 84 Oeken J, Meister E, Behrendt W. [Metastasis of adenocarcinoma of the ovary to the subglottis. A laryngologic rarity]. HNO 1996; 44 (01) 27-31
• 85 Coakley JF, Ranson DL. Metastasis to the larynx from a prostatic carcinoma. A case report. J Laryngol Otol 1984; 98 (08) 839-42
• 86 Conti M, Benhamed L, Mortuaire G. et al. Indications and results of anterior mediastinal tracheostomy for malignancies. Ann Thorac Surg 2010; 89 (05) 1588-95
• 87 Yamasaki T, Komasawa N, Fujiwara A. et al. Use of a videolaryngoscope with a tube guide for metal stent placement to subglottic tracheal tumor. J Clin Anesth 2016; 31: 229-30
• 88 Salis GB, Albertengo JC, Bruno M. et al. Pedunculated liposarcoma of the esophagus. Dis Esophagus 2017; 11 (01) 68-71
• 89 Huh J. Epidemiologic overview of malignant lymphoma. Korean J Hematol 2012; 47 (02) 92-104
• 90 Markou K, Goudakos J, Constantinidis J. et al. Primary laryngeal lymphoma: Report of three cases and review of the literature. Head and Neck 2010; (10) 541-549
• 91 Hong SA, Tajudeen BA, Choi S. et al. Epidemiology and prognostic indicators in laryngeal lymphoma: A population-based analysis. Laryngoscope. 2018 doi: 10.1002/lary.27074. [Epub ahead of print]
• 92 Kuo J, Hou Y, Chu S. et al. Subglottic stenosis induced by extranodal mucosa associated lymphoid tissue lymphoma. Journal of the Chinese medical association 2011; 74 (03) 144-147
• 93 Smith E, Rottscholl R, Brosch S. et al. [Malignant lymphoma in the larynx]. Laryngorhinootologie 2013; 92 (06) 381-8
• 94 Tan E, Mody MD, Saba NF. Systemic therapy in non-conventional cancers of the larynx. Oral Oncol. 07/2018; 82: 61-68 doi: 10.1016/j.oraloncology.2018.05.005. Epub 2018