S199 – Subglottic Stenosis: Clinical Outcomes in 131 Patients

Abstract

Objectives Evaluate outcomes of patients treated for dyspnea secondary to subglottic stenosis. Methods Retrospective medical record review of patients from February 2000-January 2008 that underwent intervention for subglottic airway stenosis. Results 131 patients ages 16 to 88 years (mean 46.68 years) (17 male and 114 female) were treated for subglottic airway obstruction. The stenosis was idiopathic in 73 (56%), traumatic in 4 (3%), Wegner's Granulomatosis in 13 (10%), and other in 41 (31%). In the idiopathic group, 73 (100%) were female. 88 (67%) of the patients had pretreatment maximum voluntary ventilation (MVV) recorded with a mean value of 52.16 (47.33 % Predicted). 16 patients with idiopathic stenosis were managed by nd-YAG laser therapy and rigid bronchoscopic dilation. 131 patients were treated with CO2 laser division of scar or dilation with Kenalog injection and Mitomycin C application. A select group underwent laryngotracheal res-construction or resection. Retreatment in the idiopathic group varied widely. The average number of treatments per patient were 2.8 with symptom control from 1 month to 4 years. Conclusions Sublglottic stenosis is a challenging clinical entity. Pulmonary function testing using the MVV can be helpful in predicting those patients that will benefit from treatment. Idiopathic subglottic stenosis is primarily a female disorder. Endoscopic management of idiopathic subglottic stenosis with CO2 laser, Kenalog, and Mitomycin C treatment improves length of symptom control compared to nd-YAG laser therapy with rigid dilation alone.