PMID- 37668331
OWN - NLM
STAT- MEDLINE
DCOM- 20240118
LR  - 20240207
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Print)
IS  - 0023-852X (Linking)
VI  - 134
IP  - 2
DP  - 2024 Feb
TI  - Association between Estrogen Exposure and Idiopathic Subglottic Stenosis.
PG  - 825-830
LID - 10.1002/lary.31030 [doi]
AB  - OBJECTIVE: Idiopathic subglottic stenosis (iSGS) is a rare, recurrent, 
      fibroinflammatory disease affecting the larynx and proximal trachea. Given it 
      occurs primarily in adult females, estrogen is speculated to play a central 
      pathophysiological role. This study aimed to evaluate relationships between 
      estrogen exposure, disease progression, and recurrence. METHODS: North American 
      Airway Collaborative (NoAAC) data of adults with iSGS obstructive airway lesions, 
      who underwent index endoscopic airway dilation, were used to identify 
      associations between estrogen exposure, disease characteristics, and time to 
      recurrence (TTR), and interventions were analyzed using Kruskal-Wallis test and 
      Pearson coefficient. Cox proportional hazards regression models compared hazard 
      ratios by estrogen exposure. Kaplan-Meier curves were plotted for TTR based on 
      menopausal status. RESULTS: In all, 533 females had complete estrogen data (33% 
      premenopausal, 17% perimenopausal, 50% postmenopausal). Median estrogen exposure 
      was 28 years. Overall, there was no dose-response relationship between estrogen 
      exposure and disease recurrence. Premenopausal patients had significantly shorter 
      time from symptom manifestation to diagnosis (1.17 vs. 1.42 years perimenopausal 
      vs. 2.08 years postmenopausal, p < 0.001), shorter time from diagnosis to index 
      endoscopic airway dilation (1.90 vs. 2.50 vs. 3.76 years, p = 0.005), and higher 
      number of procedures (1.73 vs. 1.20 vs. 1.08 procedures, p < 0.001). CONCLUSIONS: 
      We demonstrate premenopausal patients may have a more aggressive disease variant 
      than their peri- and postmenopausal counterparts. However, it is unclear as to 
      whether this is related to reduced estrogen in the peri- and postmenopausal 
      states or the age-related physiology of wound healing and inflammation, 
      regardless of estrogen. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:825-830, 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 - Nanda, Nainika
AU  - Nanda N
AUID- ORCID: 0000-0002-1043-8546
AD  - Division of Otolaryngology-Head and Neck Surgery, University of 
      Wisconsin-Madison, Madison, Wisconsin, U.S.A.
FAU - Huang, Li-Ching
AU  - Huang LC
AD  - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, U.S.A.
FAU - Chen, Sheau-Chiann
AU  - Chen SC
AD  - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, U.S.A.
FAU - Berry, Lynne D
AU  - Berry LD
AD  - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, U.S.A.
FAU - Talatala, Edward Ryan R
AU  - Talatala ERR
AUID- ORCID: 0000-0002-6288-7255
AD  - Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, U.S.A.
FAU - Clark, Evan
AU  - Clark E
AUID- ORCID: 0000-0002-4951-2627
AD  - Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, U.S.A.
FAU - Ye, Wenda
AU  - Ye W
AD  - Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, U.S.A.
FAU - Gelbard, Alexander
AU  - Gelbard A
AUID- ORCID: 0000-0003-0078-1305
AD  - Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, U.S.A.
FAU - Francis, David O
AU  - Francis DO
AD  - Division of Otolaryngology-Head and Neck Surgery, University of 
      Wisconsin-Madison, Madison, Wisconsin, U.S.A.
CN  - North American Airway Collaborative
LA  - eng
GR  - 1409-22214/PCORI/Patient-Centered Outcomes Research Institute/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
GR  - R01HL146401/HL/NHLBI NIH HHS/United States
GR  - R01 CA251566/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20230905
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
RN  - 0 (Estrogens)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Constriction, Pathologic/pathology
MH  - *Laryngostenosis/etiology/pathology
MH  - *Larynx/pathology
MH  - Trachea/pathology
MH  - Estrogens
PMC - PMC10842213
MID - NIHMS1940119
OTO - NOTNLM
OT  - airway stenosis
OT  - estrogen
OT  - idiopathic subglottic stenosis
OT  - laryngeal stenosis
OT  - sex
COIS- The authors report no conflicts of interest.
EDAT- 2023/09/05 12:42
MHDA- 2024/01/18 06:42
PMCR- 2025/02/01
CRDT- 2023/09/05 08:33
PHST- 2023/07/18 00:00 [revised]
PHST- 2023/04/05 00:00 [received]
PHST- 2023/08/22 00:00 [accepted]
PHST- 2025/02/01 00:00 [pmc-release]
PHST- 2024/01/18 06:42 [medline]
PHST- 2023/09/05 12:42 [pubmed]
PHST- 2023/09/05 08:33 [entrez]
AID - 10.1002/lary.31030 [doi]
PST - ppublish
SO  - Laryngoscope. 2024 Feb;134(2):825-830. doi: 10.1002/lary.31030. Epub 2023 Sep 5.