Subglottic stenosis: a ten-year review of treatment outcomes

Laryngoscope. 2014 Mar;124(3):736-41. doi: 10.1002/lary.24410. Epub 2013 Oct 22.

Abstract

Objectives/hypothesis: To evaluate the endoscopic surgical management of adult subglottic stenosis and describe treatment outcomes.

Study design: Retrospective review.

Methods: Ten-year review of adult patients with subglottic stenosis.

Results: Ninety-two adults (23 male, 69 female) with subglottic stenosis underwent 247 endoscopic dilations between 2001 and 2010. The mean age was 48 years at time of first surgery. Etiology was GPA (granulomatosis with polyangiitis, formerly Wegener's granulomatosis) (45%), intubation (25%), or idiopathic (33%). Forty-one patients (45%) underwent a single procedure; 51 patients (55%) required multiple surgeries. The average interval for patients requiring a subsequent procedure was 13.7 months. Variations in surgical technique did not show differences in time to next procedure, and the use of mitomycin-C did not result in longer intervals between procedures. No significant complications were encountered after dilation.

Conclusions: Subglottic stenosis remains a treatment challenge. Although patients are often symptomatically improved after endoscopic dilation, recurrence rates remain high.

Keywords: Subglottis; Voice Handicap Index; adult subglottic stenosis; laser lysis of subglottic scar; mitomycin C; subglottic balloon dilation; subglottic stenosis.

Publication types

  • Evaluation Study

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Cohort Studies
  • Dilatation / instrumentation
  • Dilatation / methods
  • Female
  • Follow-Up Studies
  • Glottis / physiopathology*
  • Glottis / surgery
  • Humans
  • Laryngoscopy / methods*
  • Laryngostenosis / diagnosis
  • Laryngostenosis / drug therapy
  • Laryngostenosis / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Mitomycin / therapeutic use
  • Recurrence
  • Reoperation / methods
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Mitomycin