Cricoid chondritis: A rare and reversible etiology of airway stenosis

Objectives: Chondritis of the cricoid cartilage is a rare cause of airway stenosis that may occur after endotracheal intubation, particularly in the setting of trauma. Patients may present with significant airway compromise that is reversible if recognized and treated promptly. We describe the radiological appearance of cricoid chondritis on computed tomography (CT) imaging as a possible adjunct for prompt diagnosis. Design: Case series of two patients. Setting: Tertiary referral center. Participants: Twenty and seventeen year-old male patients. Main outcome measure: Appearance on CT and clinical course. Results: We report two cases of young gentlemen who presented with dyspnea, stridor, and dysphonia after prolonged endotracheal intubation for polytrauma. Both patients had findings of subglottic narrowing, vocal fold edema and erythema, and reduced vocal fold abduction on laryngoscopy. CT revealed sclerosis and destruction of the cricoid cartilage. Both patients underwent a single endoscopic airway surgery with steroid injection and balloon dilation, as well as oral antibiotic and steroid therapy. They reported subjective improvement in their symptoms and had near complete resolution of their glottic and subglottic abnormalities on laryngoscopy. Neither patient has had recurrence of their stenosis at most recent follow up. Conclusions: Chondritis of the cricoid cartilage may occur following intubation and presents with airway compromise that is reversible with treatment. Prompt diagnosis with adjunctive CT imaging facilitates early intervention, possibly preventing maturation of airway stenosis and development of abscess. Antibiotics should be considered in addition to surgical management.