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Area of Science:

  • Otolaryngology
  • Pulmonology
  • Regenerative Medicine

Background:

  • Idiopathic subglottic stenosis (iSGS) is a rare condition causing airway narrowing.
  • Current treatments for iSGS often involve surgical intervention with potential for recurrence.
  • In-office serial intralesional steroid injection (SILSI) is being explored as a less invasive therapeutic option.

Purpose of the Study:

  • To critically evaluate clinical and voice-related outcomes of SILSI in adult iSGS patients.
  • To assess the efficacy and safety of SILSI as an adjunctive therapy for iSGS.

Main Methods:

  • Systematic literature search of multiple databases (MEDLINE, Embase, CINAHL Ultimate, CENTRAL, ClinicalTrials.gov) up to April 2025.
  • Inclusion of studies reporting on adult SILSI recipients with iSGS.
  • Independent screening and review of articles for treatment variables, clinical outcomes, respiratory function, vocal outcomes, and complications.

Main Results:

  • 14 studies (n=371) met inclusion criteria; triamcinolone was the most common steroid used.
  • Variability noted in steroid dosage, treatment sessions, and injection intervals.
  • Observed improvements in surgery-free interval, peak expiratory flow, dyspnea index, stenosis severity, and voice outcomes; no major complications reported.

Conclusions:

  • SILSI appears to be a promising adjunctive therapy for iSGS, showing benefits in multiple outcome measures.
  • Significant variability in steroid regimens and inconsistent outcome reporting hinder definitive efficacy interpretation.
  • Further standardized research is needed to optimize SILSI protocols and confirm its long-term effectiveness in iSGS management.