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Association between Estrogen Exposure and Idiopathic Subglottic Stenosis
Nainika Nanda1, Li-Ching Huang2, Sheau-Chiann Chen2
1Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
The Laryngoscope
|September 5, 2023
Summary
Premenopausal women with idiopathic subglottic stenosis (iSGS) may experience a more aggressive disease course. Estrogen exposure did not show a dose-response relationship with iSGS recurrence in this study.
Area of Science:
- Otolaryngology
- Pulmonology
- Endocrinology
Background:
- Idiopathic subglottic stenosis (iSGS) is a rare, recurrent, fibroinflammatory airway disease primarily affecting adult women.
- Estrogen's role in iSGS pathophysiology is suspected due to the disease's predilection for females.
Purpose of the Study:
- To investigate the association between estrogen exposure, iSGS disease progression, and recurrence.
- To analyze disease characteristics and time to recurrence (TTR) in relation to menopausal status.
Main Methods:
- Analysis of North American Airway Collaborative (NoAAC) data from adult iSGS patients.
- Statistical analysis including Kruskal-Wallis, Pearson correlation, Cox regression, and Kaplan-Meier curves.
Main Results:
- No dose-response relationship was found between estrogen exposure and iSGS recurrence.
- Premenopausal patients exhibited significantly shorter times from symptom onset to diagnosis and diagnosis to treatment.
- Premenopausal women required a higher number of procedures for iSGS management.
Conclusions:
- Premenopausal iSGS patients may present with a more aggressive disease variant.
- The observed differences may relate to estrogen levels or age-related physiological factors in wound healing and inflammation.
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