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Comparing Intraoperative and In-Office Steroid Injections for Management of Subglottic Stenosis.

Fatemeh Ramazani1, J Douglas Bosch1, Derrick R Randall1

  • 1Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.

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|November 9, 2024
PubMed
Summary

Corticosteroid injections for subglottic stenosis (SGS) did not improve surgery-free intervals (SFI). Serial intralesional steroid injections (SILSI) also showed no significant benefit for idiopathic SGS patients.

Keywords:
dilationsteroidsubglottic stenosis

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Respiratory Medicine

Background:

  • Subglottic stenosis (SGS) management aims to prolong the surgery-free interval (SFI).
  • Intralesional corticosteroid injections are a proposed method to improve SFI in SGS patients.

Purpose of the Study:

  • To compare the SFI in idiopathic SGS (iSGS) patients based on treatment modality.
  • Evaluate the efficacy of endoscopic dilation alone versus dilation with intraoperative corticosteroid injection, and dilation with serial intralesional steroid injections (SILSI).

Main Methods:

  • Retrospective review of 104 iSGS patients undergoing 305 procedures between 2012 and 2023.
  • Surgery-free interval (SFI) calculated from surgical intervention dates.
  • Independent samples median test used for statistical comparison between treatment groups.

Main Results:

  • Endoscopic dilation alone yielded a longer median SFI (658 days) compared to a single intraoperative steroid injection (395 days).
  • Patients receiving a single intraoperative steroid injection had a significantly shorter SFI than those treated with dilation alone (p=0.001).
  • Transitioning to serial intralesional steroid injections (SILSI) after initial dilation and intraoperative injection resulted in a statistically significant decrease in SFI (p=0.032).

Conclusions:

  • Single intraoperative corticosteroid injections are associated with shorter surgery-free intervals in iSGS patients compared to dilation alone.
  • Serial intralesional steroid injections (SILSI) did not demonstrate a significant improvement in SFI for this patient population.