PMID- 36840325
OWN - NLM
STAT- MEDLINE
DCOM- 20230913
LR  - 20230913
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 132
IP  - 11
DP  - 2023 Nov
TI  - Long-Term Follow-up of 64 Patients With Idiopathic Subglottic Stenosis: Treatment 
      Pathways, Outcomes, and Impact of Serial Intralesional Steroid Injections.
PG  - 1341-1348
LID - 10.1177/00034894231156122 [doi]
AB  - OBJECTIVE: To describe treatment pathways and long-term outcomes in 64 patients 
      with idiopathic subglottic stenosis (iSGS), including the impact of serial 
      intralesional steroid injection (SILSI) on degree of stenosis, need for 
      subsequent operation, and patient-reported outcome measures. METHODS: 
      Retrospective review of 64 female patients with iSGS undergoing varied management 
      approaches, 57 of whom underwent SILSI as at least part of their care. Treatment 
      pathways included SILSI only, endoscopic intervention followed by SILSI only, 
      endoscopic interventions only, endoscopic intervention followed by SILSI followed 
      by need for repeat endoscopic intervention, open surgery, and tracheotomy. 
      Outcomes assessed included subjectively estimated percent airway stenosis, 
      dyspnea index (DI), modified medical research council (MMRC) dyspnea scale, voice 
      handicap index-10 (VHI-10), number of operative and office-based procedures 
      performed, need for subsequent operative intervention, and inter-operative 
      interval. RESULTS: Treatment pathways included SILSI alone (n = 6), endoscopic 
      intervention(s) followed by SILSI only (n = 31), SILSI followed by additional 
      endoscopic or office-based procedures (n = 16), open surgery (n = 3), and 
      tracheostomy (n = 4). 57 of 64 patients underwent SILSI as at least part of their 
      treatment. Inter-operative interval was increased after starting SILSI. Of 
      patients undergoing SILSI, those with more procedures or shorter inter-operative 
      interval prior to SILSI were more likely to return to the operating room. 
      Estimated stenosis, DI, MMRC, and VHI-10 decreased with SILSI. Stenosis was not 
      correlated with DI, MMRC, or VHI-10, though DI was correlated with both MMRC and 
      VHI-10 score. CONCLUSION: Of 57 patients undergoing SILSI, 37 did not require 
      further operative intervention. Improvements in inter-operative interval, 
      dyspnea, and voice were observed across patients. Randomized trials to identify 
      which patients may benefit most from SILSI are warranted.
FAU - Schoeff, Stephen
AU  - Schoeff S
AD  - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, 
      University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
FAU - Hoffman, Matthew R
AU  - Hoffman MR
AUID- ORCID: 0000-0002-1923-0039
AD  - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, 
      University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa 
      City, IA, USA.
FAU - Zhang, Yanchen
AU  - Zhang Y
AD  - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, 
      University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
FAU - Yang, Qiuyu
AU  - Yang Q
AD  - Department of Surgery, University of Wisconsin School of Medicine and Public 
      Health, Madison, WI, USA.
FAU - Dailey, Seth H
AU  - Dailey SH
AUID- ORCID: 0000-0002-3299-3014
AD  - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, 
      University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
LA  - eng
PT  - Journal Article
DEP - 20230224
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
RN  - 0 (Steroids)
SB  - IM
MH  - Humans
MH  - Female
MH  - Follow-Up Studies
MH  - Treatment Outcome
MH  - *Endoscopy/methods
MH  - Steroids/therapeutic use
MH  - *Laryngostenosis/surgery
MH  - Retrospective Studies
MH  - Injections, Intralesional
MH  - Dyspnea/etiology
OTO - NOTNLM
OT  - dyspnea index
OT  - endoscopic dilation
OT  - idiopathic subglottic stenosis
OT  - serial intralesional steroid injections
EDAT- 2023/02/26 06:00
MHDA- 2023/09/13 06:42
CRDT- 2023/02/25 04:28
PHST- 2023/09/13 06:42 [medline]
PHST- 2023/02/26 06:00 [pubmed]
PHST- 2023/02/25 04:28 [entrez]
AID - 10.1177/00034894231156122 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2023 Nov;132(11):1341-1348. doi: 
      10.1177/00034894231156122. Epub 2023 Feb 24.