Guidelines for the Management of Adult Subglottic and Tracheal Stenosis from the Korean Bronchoesophgological Society

Subglottic stenosis (SGS) and tracheal stenosis (TS) is a rare condition that can cause significant breathing difficulties and, if not managed properly, may lead to life-threatening complications. Despite its clinical importance, there is ongoing controversy regarding the optimal management of adult SGS and TS, and no comprehensive guidelines have been established to date. The Korean Bronchoesophagological Society appointed a task force to formulate clinical practice guidelines, intending to develop evidence-based recommendations for managing SGS and TS in adults. The task force conducted a systematic review of relevant literature by searching PubMed, EMBASE, and the Cochrane Library using predefined search terms aligned with key clinical questions. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, which also guided the development and reporting of the recommendations. The strength of each recommendation reflects the guideline panel's confidence that the benefits of an intervention outweigh the risks for eligible patients. After drafting the guidelines, feedback was obtained through Delphi questionnaires completed by members of the Korean Bronchoesophagological Society. Finally, the committee developed 17 evidence-based recommendations across four categories: initial evaluation, medical management, surgical treatment, and postoperative management and rehabilitation. These guidelines aim to support clinicians in providing optimal care for adult patients with SGS and TS.