Related Experiment Video
Updated: Mar 6, 2026
14:15
A Heterotopic Mouse Model for Studying Laryngeal Transplantation
Published on: January 13, 2023
3.3K
Systemic Immunosuppression to Reduce Surgical Intervention in ANCA-Negative Subglottic Stenosis
Guy Benshetrit1,2, Stephen McAdoo2,3, Romana Kuchai1,2
1National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
The Laryngoscope
|March 4, 2026
Summary
Systemic immunosuppression combined with surgery may improve outcomes for patients with aggressive idiopathic subglottic stenosis (iSGS) and granulomatosis with polyangiitis (GPA-SGS). This approach can prolong disease-free intervals, offering new hope for managing this challenging airway condition.
Area of Science:
- Otolaryngology
- Immunology
- Pulmonology
Background:
- Idiopathic subglottic stenosis (iSGS) presents a clinical challenge due to its unclear etiology and recurrent nature.
- Current management primarily relies on surgical dilatation, often yielding suboptimal long-term results for a subset of patients.
- Aggressive forms of subglottic stenosis (SGS) necessitate exploring adjunctive therapies beyond surgery.
Purpose of the Study:
- To evaluate the efficacy of systemic immunosuppression as an adjunct to surgical management in patients with aggressive iSGS and granulomatosis with polyangiitis SGS (GPA-SGS).
- To assess the impact of immunosuppressive therapy on disease activity and inter-dilation intervals (IDI) in these patient cohorts.
Main Methods:
- Retrospective analysis of patients with isolated SGS at a tertiary airway center.
- Cohort classification into iSGS, GPA-SGS, and a sub-cohort of aggressive iSGS termed 'atypical-SGS'.
- Systemic immunosuppression was administered to atypical-SGS and GPA-SGS cohorts alongside surgery; disease activity was monitored via IDI before and after treatment.
Main Results:
- The study included 60 patients: 33 iSGS, 20 GPA-SGS, and 7 atypical SGS.
- Idiopathic SGS patients showed an indolent course without immunosuppression (median IDI: 17.6 months).
- GPA-SGS and atypical SGS cohorts demonstrated significantly prolonged IDI after immunosuppression (26.0 and 27.8 months, respectively) compared to pre-treatment intervals (p<0.05).
- No significant adverse events were reported with immunosuppressive therapy.
Conclusions:
- Atypical SGS represents a distinct, aggressive subtype of SGS requiring tailored management.
- Systemic immunosuppression, typically used for GPA, effectively extends disease-free intervals in both GPA-SGS and atypical SGS.
- Findings support considering immunotherapy for frequently recurring, ANCA-negative SGS, emphasizing multidisciplinary care.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
390
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
390
01:20Myasthenia Gravis: Overview and Treatment
3.2K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
3.2K
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
1.8K
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
1.8K
01:23Chronic Pharyngitis
13.6K
Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
13.6K
01:26Tonsillitis II: Management
495
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
495
01:26Esophageal Strictures-II: Clinical Features and Management
801
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
801