PMID- 36286239 OWN - NLM STAT- MEDLINE DCOM- 20230811 LR - 20230830 IS - 1531-4995 (Electronic) IS - 0023-852X (Print) IS - 0023-852X (Linking) VI - 133 IP - 9 DP - 2023 Sep TI - Impact of Serial Intralesional Steroid Injections on Idiopathic Subglottic Stenosis. PG - 2255-2263 LID - 10.1002/lary.30449 [doi] AB - OBJECTIVES: Serial intralesional steroid injection (SILSI) has been increasingly used to treat idiopathic subglottic stenosis (iSGS). Prior studies have shown effectiveness, but not in all patients. This multi-institutional study evaluates the effect of SILSI on time to recurrent operation, peak expiratory flow (PEF), and dyspnea. METHODS: Post-hoc secondary analysis of the North American Airway Collaborative data were performed to evaluate the outcomes of iSGS patients undergoing and not undergoing SILSI. The primary outcome was time to recurrent operation, evaluated using Kaplan-Meier curves and Cox regression analysis. Secondary outcomes were change in PEF and clinical chronic obstructive pulmonary disease questionnaire (CCQ) score. Within patients undergoing SILSI, demographics, time from last procedure, and PEF at initiation of SILSI were evaluated to determine the effect on recurrence. RESULTS: Two hundred and ninety patients were included, 238 undergoing endoscopic dilation alone and 52 undergoing dilation and SILSI. No differences in baseline characteristics were observed. There was no difference in time to recurrence (hazard ratio: 0.64; p = 0.183). There were no differences in PEF or CCQ across the 2.5-year study period. Among 52 patients undergoing SILSI, PEF at the time of starting SILSI did not affect recurrence (chi(2) = 0.09, p = 0.77). CONCLUSION: Patients undergoing and not undergoing SILSI had similar times to recurrence, PEF, and CCQ. Factors predicting recurrence among patients undergoing SILSI were not identified. These results support a randomized controlled trial with a uniform SILSI protocol to quantify the effects of SILSI on objective and subjective outcomes and help determine which iSGS patients benefit most. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:2255-2263, 2023. CI - (c) 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc. FAU - Hoffman, Matthew R AU - Hoffman MR AUID- ORCID: 0000-0002-1923-0039 AD - Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. AD - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. AD - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. FAU - Patro, Ankita AU - Patro A AUID- ORCID: 0000-0001-8370-9071 AD - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Huang, Li-Ching AU - Huang LC AD - Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA. FAU - Chen, Sheau-Chiann AU - Chen SC AD - Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA. FAU - Berry, Lynn D AU - Berry LD AD - Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA. FAU - Gelbard, Alexander AU - Gelbard A AUID- ORCID: 0000-0003-0078-1305 AD - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Francis, David O AU - Francis DO AD - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. CN - North American Airway Collaborative LA - eng GR - R01 CA251566/CA/NCI NIH HHS/United States GR - K23 DC013559/DC/NIDCD NIH HHS/United States GR - R01 HL146401/HL/NHLBI NIH HHS/United States GR - R21 DC016724/DC/NIDCD NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20221026 PL - United States TA - Laryngoscope JT - The Laryngoscope JID - 8607378 RN - 0 (Steroids) SB - IM MH - Humans MH - Constriction, Pathologic/complications MH - Treatment Outcome MH - *Laryngostenosis/surgery MH - Steroids/therapeutic use MH - Endoscopy MH - Injections, Intralesional PMC - PMC10130237 MID - NIHMS1841025 OTO - NOTNLM OT - endoscopic dilation OT - idiopathic subglottic stenosis OT - peak expiratory flow OT - serial intralesional steroid injection COIS- Conflicts of Interest: None. FIR - Anderson, Catherine IR - Anderson C FIR - Amin, Milan R IR - Amin MR FIR - Benninger, Michael S IR - Benninger MS FIR - Blumin, Joel H IR - Blumin JH FIR - Bock, Jonathan M IR - Bock JM FIR - Bryson, Paul C IR - Bryson PC FIR - Castellanos, Paul F IR - Castellanos PF FIR - Clary, Matthew S IR - Clary MS FIR - Cohen, Seth M IR - Cohen SM FIR - Crawley, Brianna K IR - Crawley BK FIR - Dailey, Seth H IR - Dailey SH FIR - Daniero, James J IR - Daniero JJ FIR - de Alarcon, Alessandro IR - de Alarcon A FIR - Donovan, Donald T IR - Donovan DT FIR - Edell, Eric S IR - Edell ES FIR - Ekbom, Dale C IR - Ekbom DC FIR - Fink, Daniel S IR - Fink DS FIR - Franco, Ramon A IR - Franco RA FIR - Garrett, C Gaelyn IR - Garrett CG FIR - Guardiani, Elizabeth A IR - Guardiani EA FIR - Hillel, Alexander T IR - Hillel AT FIR - Hoffman, Henry T IR - Hoffman HT FIR - Hogikyan, Norman D IR - Hogikyan ND FIR - Howell, Rebecca J IR - Howell RJ FIR - Johns, Michael M IR - Johns MM FIR - Kasperbauer, Jan L IR - Kasperbauer JL FIR - Khosla, Sid M IR - Khosla SM FIR - Kinnard, Cheryl IR - Kinnard C FIR - Kupfer, Robbi A IR - Kupfer RA FIR - Langerman, Alexander J IR - Langerman AJ FIR - Lentz, Robert J IR - Lentz RJ FIR - Lorenz, Robert R IR - Lorenz RR FIR - Lott, David G IR - Lott DG FIR - Makani, Samir S IR - Makani SS FIR - Maldonado, Fabien IR - Maldonado F FIR - Mannion, Kyle IR - Mannion K FIR - Matrka, Laura IR - Matrka L FIR - McWhorter, Andrew J IR - McWhorter AJ FIR - Merati, Albert L IR - Merati AL FIR - Mori, Matthew IR - Mori M FIR - Netterville, James L IR - Netterville JL FIR - O'Dell, Karla IR - O'Dell K FIR - Ongkasuwan, Julina IR - Ongkasuwan J FIR - Postma, Gregory N IR - Postma GN FIR - Reder, Lindsay S IR - Reder LS FIR - Rohde, Sarah L IR - Rohde SL FIR - Richardson, Brent E IR - Richardson BE FIR - Rickman, Otis B IR - Rickman OB FIR - Rosen, Clark A IR - Rosen CA FIR - Rutter, Michael J IR - Rutter MJ FIR - Sandhu, Guri S IR - Sandhu GS FIR - Schindler, Joshua S IR - Schindler JS FIR - Schneider, G Todd T IR - Schneider GTT FIR - Shah, Rupali N IR - Shah RN FIR - Sikora, Andrew G IR - Sikora AG FIR - Sinard, Robert J IR - Sinard RJ FIR - Smith, Marshall E IR - Smith ME FIR - Smith, Libby J IR - Smith LJ FIR - Soliman, Ahmed Ms IR - Soliman AM FIR - Sveinsdottir, Sigriethur IR - Sveinsdottir S FIR - Van Daele, Douglas J IR - Van Daele DJ FIR - Veivers, David IR - Veivers D FIR - Verma, Sunil P IR - Verma SP FIR - Weinberger, Paul M IR - Weinberger PM FIR - Weissbrod, Philip A IR - Weissbrod PA FIR - Wootten, Christopher T IR - Wootten CT FIR - Shyr, Yu IR - Shyr Y EDAT- 2022/10/27 06:00 MHDA- 2023/08/11 06:42 PMCR- 2024/09/01 CRDT- 2022/10/26 07:53 PHST- 2022/08/29 00:00 [revised] PHST- 2022/04/07 00:00 [received] PHST- 2022/09/06 00:00 [accepted] PHST- 2024/09/01 00:00 [pmc-release] PHST- 2023/08/11 06:42 [medline] PHST- 2022/10/27 06:00 [pubmed] PHST- 2022/10/26 07:53 [entrez] AID - 10.1002/lary.30449 [doi] PST - ppublish SO - Laryngoscope. 2023 Sep;133(9):2255-2263. doi: 10.1002/lary.30449. Epub 2022 Oct 26.