Office-based corticosteroid injections as adjuvant therapy for subglottic stenosis.
Laryngoscope Investig Otolaryngol
; 4(4): 414-419, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31453351
ABSTRACT
OBJECTIVE:
Subglottic stenosis (SGS) is a serious, potentially life-threatening disorder that is difficult to treat due to significant recurrence rates. While conventional treatment of SGS relies heavily on serial endoscopic dilation procedures, this study aims to characterize the efficacy of incorporating subglottic corticosteroid injections in increasing surgery-free intervals (SFIs) for a cohort of patients at a university-based medical system. STUDYDESIGN:
Retrospective chart review.METHODS:
All SGS patients who underwent endoscopic dilation and at least one adjuvant office-based serial intralesional steroid injection (SILSI) were reviewed. Patients were excluded if they had synchronous airway lesions or stenosis outside of the subglottis. Charts were reviewed for demographic and treatment-specific data. The SFI was calculated for patients both prior to the initiation of SILSI and after. Groups were compared via Mann-Whitney U test, with P < .05 as the threshold for significance.RESULTS:
Thirteen patients met criteria, with mean age 50.1 ± 14.1 years and 76 female to male ratio. Eight of the thirteen (61.5%) had intubation-related stenosis, while 4/13 were idiopathic and 1/13 was due to Wegener's granulomatosis. Mean follow-up was 20.4 months. Patients underwent an average of 4.2 ± 2.2 postoperative injections, beginning 45.9 ± 19.0 days after surgery. The mean SFI prior to initiating SILSI was 288.6 ± 362.0 days; while after receiving SILSI, the mean interval was significantly longer (545.5 ± 152.7 days, P = .0041).CONCLUSIONS:
We demonstrate that office-based corticosteroid injection for SGS was associated with a statistically significant improvement in the SFI and is a promising adjuvant approach. Future prospective studies should evaluate if the efficacy is reproducible on a large scale and if SILSI can and/or should be incorporated into the standard management paradigm for SGS treatment. LEVEL OF EVIDENCE 4.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article