In-Office Balloon Dilation for Idiopathic Subglottic Stenosis: A Pilot Study

Area of Science:

• Otolaryngology
• Respiratory Medicine
• Minimally Invasive Procedures

Background:

• Idiopathic subglottic stenosis (iSGS) is a debilitating condition often requiring repeated treatments.
• Traditional balloon dilation for iSGS is typically performed under general anesthesia.
• In-office, awake balloon dilation presents a potentially less burdensome alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of in-office balloon dilation for mild to moderate iSGS.
• To assess patient-reported outcomes and objective airway measurements post-procedure.

Main Methods:

• A mixed-methods study involving 11 adult patients with Cotton-Myer Grade I-II iSGS.
• In-office balloon dilation was performed between June 2022 and August 2023.
• Pre- and post-procedure data included validated dyspnea and voice scales, airway diameter, and spirometry.

Main Results:

• Significant improvements were observed in dyspnea and voice handicap scores.
• Airway stenosis decreased from a median of 40% to 10% (P=.003).
• Peak expiratory flow increased significantly (P=.004), with a median recovery time of one day.

Conclusions:

• In-office balloon dilation is a safe and effective treatment for mild to moderate iSGS.
• The procedure leads to significant improvements in patient-reported outcomes and objective airway measures.
• Patients previously treated under general anesthesia expressed a preference for the in-office approach.