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Laryngorhinootologie 2019; 98(07): 461-472
DOI: 10.1055/a-0915-2420
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Subglottische Pathologien

Subglottic pathologies
Adrienne Heyduck
1   Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsmedizin Göttingen (Direktor Prof. Dr. D. Beutner), Robert-Koch-Str. 40, 37075 Göttingen
3   Universitäts-Hals-Nasen-Ohrenklinik Ulm (Direktor Prof. Dr. T. Hoffmann), Sektion für Phoniatrie und Pädaudiologie (Leiterin Prof. Dr. S. Brosch), Frauensteige 12, 89075 Ulm
,
Anja Pickhard
2   Hals-Nasen-Ohrenklinik der Technischen Universität München (Direktor Prof. Dr. H. Bier), Ismaninger Straße 22, 81675 München
,
Sibylle Brosch
3   Universitäts-Hals-Nasen-Ohrenklinik Ulm (Direktor Prof. Dr. T. Hoffmann), Sektion für Phoniatrie und Pädaudiologie (Leiterin Prof. Dr. S. Brosch), Frauensteige 12, 89075 Ulm
,
Thomas K. Hoffmann
4   Universitäts-Hals-Nasen-Ohrenklinik Ulm (Direktor Prof. Dr. T.K. Hoffmann), Frauensteige 12, 89075 Ulm
,
Rudolf Reiter
3   Universitäts-Hals-Nasen-Ohrenklinik Ulm (Direktor Prof. Dr. T. Hoffmann), Sektion für Phoniatrie und Pädaudiologie (Leiterin Prof. Dr. S. Brosch), Frauensteige 12, 89075 Ulm
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Publikationsverlauf

25. Oktober 2018

30. April 2019

Publikationsdatum:
10. Juli 2019 (online)

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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
 

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