PMID- 37668329
OWN - NLM
STAT- MEDLINE
DCOM- 20240118
LR  - 20240118
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 134
IP  - 2
DP  - 2024 Feb
TI  - Decision-Making in the Treatment of Idiopathic Subglottic Stenosis: A Survey of 
      Laryngologists.
PG  - 865-872
LID - 10.1002/lary.31028 [doi]
AB  - OBJECTIVE: Idiopathic subglottic stenosis (iSGS) is a rare condition involving 
      the subglottic larynx and upper trachea, commonly affecting Caucasian females 
      between 30 and 50 years of age. Despite its homogeneous presentation, clinical 
      management for iSGS is yet to be standardized, leading to variability in outcomes 
      between predominant interventions. In recognition of the heterogenicity in iSGS 
      treatment and the need to improve patient outcomes, this study aimed to survey 
      laryngologists to understand the factors influencing clinical decision-making and 
      the incorporation of new treatment modalities for iSGS. METHODS: An online survey 
      was sent to 145 academic laryngologists. The survey assessed respondents' 
      professional backgrounds, experience treating iSGS, treatment algorithms, and how 
      various patient factors affect management. RESULTS: Of the 87 (60%) 
      laryngologists who responded to the survey, the most common clinical assessments 
      were tracheoscopy/bronchoscopy (96.8%) and pulmonary function tests (43.6%). 
      Endoscopic dilation (ED) was the most common primary treatment offered (97.5%): 
      28.7% of surveyed laryngologists offer SISI as a primary treatment, and 74.7% 
      perform SISI as a planned postoperative treatment. The most common SISI protocol 
      was repeated injections every 4-6 weeks for a series of 1-3 total injections. 
      Notably, 9.2% perform the Maddern procedure. Routine algorithms of care involving 
      surgery were most often based on prior experience and prior patient outcomes 
      (75.9%) and conversations with colleagues (64.4%). Only 31% report using the same 
      protocol learned during their fellowship training. CONCLUSION: This survey 
      highlights significant variation in the management of patients with iSGS. 
      Understanding the factors that influence decision-making may lead to potential 
      standardization in heterogeneous treatment approaches and may improve clinical 
      outcomes. LEVEL OF EVIDENCE: 5 Laryngoscope, 134:865-872, 2024.
CI  - (c) 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf 
      of The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Razura, Diego E
AU  - Razura DE
AUID- ORCID: 0000-0002-0133-3582
AD  - Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of 
      Medicine, University of Southern California, Los Angeles, California, U.S.A.
FAU - Bensoussan, Yael
AU  - Bensoussan Y
AUID- ORCID: 0000-0002-1635-8627
AD  - Division of Laryngology, Department of Otolaryngology - Head & Neck Surgery, 
      University of South Florida, Tampa, Florida, U.S.A.
FAU - Lui, Christopher G
AU  - Lui CG
AUID- ORCID: 0000-0002-2904-6745
AD  - Department of Otolaryngology - Head and Neck Surgery, Feinberg School of 
      Medicine, Northwestern University, Chicago, Illinois, U.S.A.
FAU - Johns, Michael M 3rd
AU  - Johns MM 3rd
AD  - Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of 
      Medicine, University of Southern California, Los Angeles, California, U.S.A.
FAU - Reder, Lindsay
AU  - Reder L
AD  - Southern California Permanente Medical Group, Kaiser Permanente Baldwin Park, 
      Baldwin Park, California, U.S.A.
FAU - Gelbard, Alexander
AU  - Gelbard A
AD  - Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, 
      Tennessee, U.S.A.
FAU - O'Dell, Karla
AU  - O'Dell K
AUID- ORCID: 0000-0002-0208-1647
AD  - Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of 
      Medicine, University of Southern California, Los Angeles, California, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20230905
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Female
MH  - Humans
MH  - Constriction, Pathologic
MH  - *Laryngostenosis/surgery
MH  - *Larynx
MH  - Trachea/surgery
MH  - Endoscopy/methods
OTO - NOTNLM
OT  - iSGS
OT  - idiopathic subglottic stenosis
OT  - laryngotracheal stenosis
OT  - physician experience
OT  - survey
EDAT- 2023/09/05 12:43
MHDA- 2024/01/18 06:42
CRDT- 2023/09/05 08:33
PHST- 2023/07/19 00:00 [revised]
PHST- 2023/04/27 00:00 [received]
PHST- 2023/08/22 00:00 [accepted]
PHST- 2024/01/18 06:42 [medline]
PHST- 2023/09/05 12:43 [pubmed]
PHST- 2023/09/05 08:33 [entrez]
AID - 10.1002/lary.31028 [doi]
PST - ppublish
SO  - Laryngoscope. 2024 Feb;134(2):865-872. doi: 10.1002/lary.31028. Epub 2023 Sep 5.