Voice‐Related Quality of Life Is Associated with Postoperative Change in Subglottic Stenosis

Abstract

Objectives To characterize the impact of subglottic stenosis (SGS) on voice‐related quality of life (V‐RQOL) and quantify the effect of treatment on voice outcomes. Study Design Case series. Methods Retrospective review of SGS patients treated from 1996 to 2018 at a single institution to assess for 1) V‐RQOL association with individual patient cumulative treatment number and 2) V‐RQOL correlation with treatment type, time between treatments, and degree of stenosis. Analysis included both parametric and nonparametric statistical comparison across treatment types and multivariable and univariate linear regression. Results Sixty‐one patients, predominantly white (93%) and female (93%), were included. Etiology of SGS included idiopathic (61%), iatrogenic (16%), granulomatosis with polyangiitis (16%), and other (7%). The plurality of patients had four or more treatments (44%), with the remainder having one (28%), two (13%), or three treatments (15%). Analysis of change between pre‐ and postoperative V‐RQOL scores was completed for 130 treatments. These included dilation with laser incision (52%), in‐office injection (34%), dilation without division (8%), cricotracheal resection (1%), and all other treatment (8%). For every 10% improvement in airway caliber postoperatively, there was a 1.3‐point improvement in calculated V‐RQOL (r = 0.27, P = .02). After adjustment for treatment type, age, sex, and SGS etiology, this association held (beta = 1.5, P = .02). Change in V‐RQOL was not associated with treatment type, treatment number, or time between treatments. Conclusion Patients with subglottic stenosis who have greater degree of change in airway caliber experience greater improvement in V‐RQOL scores following treatment. V‐RQOL scores are not associated with treatment type or time between individual treatments. Level of Evidence 4 Laryngoscope, 131:360–365, 2021

Long‐Term Voice Outcomes Following Cricotracheal Resection for Subglottic Stenosis: A Retrospective Analysis

“…Our findings demonstrate a significant pitch reduction for female voices following CTR, similar to other studies. 3,5,10,12,17 The serial acoustic measures show that the early postoperative pitch reduction is not permanent. Although most patients' F0 will remain below the preoperative F0 (Fig.…”

High Tracheal Resection With Intralaryngeal Extension as an Alternative to Cricotracheal Resection for Treatment of Subglottic Stenosis

“…Patients with SGS also have a high prevalence of voice disorders, 4 possibly due to airflow turbulence 5 . Voice generally improves with endoscopic dilation of SGS 5‐8 . If open airway reconstruction is required, the current standard approach is cricotracheal resection, where the anterior cricoid cartilage is removed, and the cricothyroid muscles are either transected or repositioned 9‐11 .…”

“…5 Voice generally improves with endoscopic dilation of SGS. [5][6][7][8] If open airway reconstruction is required, the current standard approach is cricotracheal resection, where the anterior cricoid cartilage is removed, and the cricothyroid muscles are either transected or repositioned. [9][10][11] However, numerous studies have shown that cricotracheal resection is associated with worsened postoperative subjective and objective voice outcomes.…”