Idiopathic Subglottic Stenosis: Long-Term Outcomes of Open Surgical Techniques

Deanna C. Menapace, Mara C. Modest, Dale C. Ekbom, Eric J. Moore, Eric Edell, Jan Kasperbauer

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objectives: Idiopathic subglottic stenosis (iSGS) is rare, and its cause remains elusive. Treatment options include empiric medical therapy and endoscopic or open surgery. We present our results for open surgical technique. Study Design: Case series with chart review (1978-2015). Setting: Tertiary academic center. Subjects/Methods: Thirty-three patients (32 female; median age, 51 years) met inclusion criteria and underwent cricotracheal resection with thyrotracheal anastomosis, tracheal resection with primary anastomosis, or laryngotracheoplasty with rib grafting. Continuous variables were summarized using medians and ranges while categorical features are presented using frequency counts and percentages. Results: Sixteen patients (48%) underwent a single-stage approach with immediate extubation or temporary intubation following surgery (median, 1 day; range, 1-3 days). Seventeen patients (52%) underwent a double-staged approach with a median time to decannulation of 35 days (range, 13-100 days). Twenty-four (73%) patients underwent a previous intervention. Median stay in the intensive care unit was 1 day (range, 0-3 days), with a median hospital stay of 4 days (range, 2-7 days). Recurrence requiring further surgical intervention was observed in 12 patients (36%). The median time to recurrence was 8 years over an average follow-up of 9.7 years. The most common complaint following surgery was change in voice quality (fair to poor; n = 10; 30%). Conclusions: Open surgery should be reserved for refractory cases of iSGS; cricotracheal resection with thyrotracheal anastomosis is the preferred open technique. Recurrence may occur after open treatment, highlighting the importance of long-term follow-up. Patients should be counseled about the potential for worsening voice quality with the open approach.

Original languageEnglish (US)
Pages (from-to)906-911
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume156
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • cricotracheal resection
  • idiopathic subglottic stenosis
  • laryngotracheoplasty
  • tracheal resection

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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