Endoscopic Management of Idiopathic Subglottic Stenosis

Abstract

Most patients with ISS can be managed endoscopically, and IDI may be increased with steroid injection. Gastroesophageal reflux disease is a common co-morbidity. Body mass index did not change over time despite potential effects on exercise tolerance; BMI did not affect IDI. Methods to determine optimal timing for next intervention are warranted.

Serial office‐based steroid injections for treatment of idiopathic subglottic stenosis

“…Patients and clinicians have grown accustomed to the need for yearly or even more frequent operations to prevent critical airway stenosis. Pharmacologic adjuncts to dilation procedures, such as mitomycin‐C and dexamethasone, as well as adjunctive laser use, have had some positive results, but the need for repeated operations and the associated risks have persisted. The potential to manage at least a subgroup of these patients with office‐based treatment alone is clinically important and could represent a shift in the way we approach this disorder.…”

Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review

“…Several studies reported a disunity in treatment over the course of the study or an intra-population variation in treatment. Heterogeneity in treatment was suspected in nine studies (60%) (1,2,5,10,12,14,16,17,19). All other studies do not specifically report a variance in endoscopic treatment (11,13,15,18,20,21).…”

“…Figure 4 shows a visual overview of the different techniques in the trials. It is striking to note that only 1 trial (6.7%) examined the use of an isolated technique (18) and 14 studies (93.3%) described the use of a combination of techniques (1,2,5,(10)(11)(12)(13)(14)(15)(16)(17)(19)(20)(21) respectively. Several studies reported a disunity in treatment over the course of the study or an intra-population variation in treatment.…”

Outcomes after cricotracheal resection for idiopathic subglottic stenosis

“…Regardless of etiology, the treatment goals center around creating an open and lasting airway and are accomplished surgically. Despite the relative homogeneity of the disease presentation and population, the treatment of iSGS remains quite variable on a spectrum from endoscopic management with balloon dilation to cricotracheal resection (CTR) . Despite CTR having less recurrence than endoscopic management, there can be significant morbidity associated with undergoing the open procedure.…”

“…Despite the relative homogeneity of the disease presentation and population, the treatment of iSGS remains quite variable on a spectrum from endoscopic management with balloon dilation to cricotracheal resection (CTR). [7][8][9][10][11] Despite CTR having less recurrence than endoscopic management, there can be significant morbidity associated with undergoing the open procedure. Questions regarding when to implement and offer CTR to the iSGS patient are important issues in the management of this condition.…”