Balloon dilatation versus CO₂ laser surgery in subglottic stenosis, a retrospective analysis of therapeutic approaches

Background: Subglottic stenosis (SGS) is a narrowing of the airway just below the vocal folds. The cause of SGS and the optimal care for these patients, have remained elusive. Endoscopic surgery of SGS using either balloon or CO₂ laser is associated with recurrence.

Aims and objectives: Our aim is to compare surgery free intervals (SFI) between these two methods applied in two different timeframes. The knowledge gained from this project can support decision-making regarding surgical method choice.

Material and methods: Participants were retrospectively identified using medical records between 1999 - 2021. We used pre-defined broad inclusion criteria to identify cases using the International Classification of Disease (ICD-10). Primary outcome was surgery free intervals.

Results: 141 patients were identified, 63 met the criteria for SGS, and were included in the analysis. Results show no significant difference in SFI, comparing balloon dilatation and CO₂ laser.

Conclusion: These findings demonstrate no detected difference in treatment intervals (SFI) when comparing these two commonly used surgical alternatives for SGS.

Significance: The outcome of this report supports surgical freedom of choice based on the surgeon's experience and skill and ushes for further studies on patient experience regarding these two therapeutic approaches.