Declining frequency of surgical interventions over time in subglottic stenosis

Soft tissue subglottic stenosis (SGS) progressively reduces the airway dimension below the vocal folds. The cause is unknown. As no cure is available patients face a recurrent need for surgical treatment. Previous research has not established whether the need for repeated interventions diminishes or intensifies as the disease evolves. Our hypothesis is that the number of surgical interventions decrease with disease duration. If true, these findings may have an impact on the surgical setting.

To investigate if the number of surgical interventions decreases with disease duration.

Participants were retrospectively included between 1999-2024 using medical records. The primary outcome measure was number of surgical interventions. A piecewise exponential additive mixed model (PAMM) was applied to assess changes in reoperation risk over time.

217 cases were identified, 60 (93% females) met the criteria for SGS. These 60 cases underwent 147 surgical procedures. There was a significant decrease in the hazard of re-operation along the timeline from the index surgery, corresponding to 7.7% annual reduction in the risk of requiring a new surgical intervention.

The risk of reoperation decreased by 7.7%/yr. (p = 0.008), reflected in increased treatment-free intervals and interpreted as decreasing disease activity.