Comparative Treatment Outcomes for Idiopathic Subglottic Stenosis: 5-Year Update

William S Tierney; Li-Ching Huang; Sheau-Chiann Chen; Lynn D Berry; Catherine Anderson; Milan R Amin; Michael S Benninger; Joel H Blumin; Jonathan M Bock; Paul C Bryson; Paul F Castellanos; Matthew S Clary; Seth M Cohen; Brianna K Crawley; Seth H Dailey; James J Daniero; Alessandro de Alarcon; Donald T Donovan; Eric S Edell; Dale C Ekbom; Daniel S Fink; Ramon A Franco; Catherine Gaelyn Garrett; Elizabeth A Guardiani; Alexander T Hillel; Henry T Hoffman; Norman D Hogikyan; Rebecca J Howell; Michael M Johns; Jan L Kasperbauer; Sid M Khosla; Cheryl Kinnard; Robbi A Kupfer; Alexander J Langerman; Robert J Lentz; Robert R Lorenz; David G Lott; Samir S Makani; Fabien Maldonado; Laura Matrka; Andrew J McWhorter; Albert L Merati; Matthew Mori; James L Netterville; Karla O'Dell; Julina Ongkasuwan; Gregory N Postma; Lindsay S Reder; Sarah L Rohde; Brent E Richardson; Otis B Rickman; Clark A Rosen; Matthew Rohlfing; Michael J Rutter; Guri S Sandhu; Joshua S Schindler; Glenn Todd Schneider; Rupali N Shah; Andrew G Sikora; Robert J Sinard; Marshall E Smith; Libby J Smith; Ahmed M S Soliman; Sigríður Sveinsdóttir; David Veivers; Sunil P Verma; Paul M Weinberger; Philip A Weissbrod; Christopher T Wootten; Yu Shyr; David O Francis; Alexander Gelbard

doi:10.1002/ohn.190

Comparative Treatment Outcomes for Idiopathic Subglottic Stenosis: 5-Year Update

Otolaryngol Head Neck Surg. 2023 Jun;168(6):1570-1575. doi: 10.1002/ohn.190. Epub 2023 Jan 19.

Authors

William S Tierney¹, Li-Ching Huang², Sheau-Chiann Chen², Lynn D Berry², Catherine Anderson¹, Milan R Amin³, Michael S Benninger⁴, Joel H Blumin⁵, Jonathan M Bock⁵, Paul C Bryson⁴, Paul F Castellanos⁶, Matthew S Clary⁷, Seth M Cohen⁸, Brianna K Crawley⁹, Seth H Dailey¹⁰, James J Daniero¹¹, Alessandro de Alarcon¹², Donald T Donovan¹³, Eric S Edell¹⁴, Dale C Ekbom¹⁵, Daniel S Fink⁷, Ramon A Franco¹⁶, Catherine Gaelyn Garrett¹, Elizabeth A Guardiani¹⁷, Alexander T Hillel¹⁸, Henry T Hoffman¹⁹, Norman D Hogikyan²⁰, Rebecca J Howell¹², Michael M Johns²¹, Jan L Kasperbauer¹⁵, Sid M Khosla¹², Cheryl Kinnard¹, Robbi A Kupfer²⁰, Alexander J Langerman¹, Robert J Lentz²², Robert R Lorenz⁴, David G Lott²³, Samir S Makani²⁴, Fabien Maldonado²², Laura Matrka²⁵, Andrew J McWhorter²⁶, Albert L Merati²⁷, Matthew Mori²⁸, James L Netterville¹, Karla O'Dell²¹, Julina Ongkasuwan¹³, Gregory N Postma²⁹, Lindsay S Reder²¹, Sarah L Rohde¹, Brent E Richardson³⁰, Otis B Rickman²², Clark A Rosen³¹, Matthew Rohlfing¹, Michael J Rutter¹², Guri S Sandhu³², Joshua S Schindler³³, Glenn Todd Schneider³⁴, Rupali N Shah³⁵, Andrew G Sikora¹³, Robert J Sinard¹, Marshall E Smith³⁶, Libby J Smith³⁷, Ahmed M S Soliman³⁸, Sigríður Sveinsdóttir³⁹, David Veivers⁴⁰, Sunil P Verma⁴¹, Paul M Weinberger⁴², Philip A Weissbrod⁴³, Christopher T Wootten¹, Yu Shyr², David O Francis¹⁰, Alexander Gelbard¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA.
³ Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
⁴ Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
⁷ Department of Otolaryngology-Head and Neck Surgery, Mercy Health-St. Rita's Ear, Nose and Throat, Lima, Ohio, USA.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver, Colorado, USA.
⁹ Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Duke University, Durham, North Carolina, USA.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, USA.
¹¹ Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA.
¹² Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
¹³ Department of Otolaryngology-Head and Neck Surgery, Baylor University, Houston, Texas, USA.
¹⁴ Department of Pulmonology, Mayo Clinic, Rochester, Minnesota, USA.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
¹⁶ Department of Otolaryngology-Head and Neck Surgery, Harvard University, Boston, Massachusetts, USA.
¹⁷ Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA.
¹⁸ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
¹⁹ Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA.
²⁰ Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
²¹ Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA.
²² Department of Medicine, Division of Pulmonology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
²³ Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA.
²⁴ Scripps Health, Coastal Pulmonary Associates, Encinitas, California, USA.
²⁵ Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA.
²⁶ Department of Otolaryngology-Head and Neck Surgery, Louisiana State University, Baton Rouge, Louisiana, USA.
²⁷ Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
²⁸ Department of Otolaryngology-Head and Neck Surgery, Mount Sinai, New York, New York, USA.
²⁹ Department of Otolaryngology-Head and Neck Surgery, Augusta University Health, Augusta, Georgia, USA.
³⁰ Department of Otolaryngology-Head and Neck Surgery, Bastian Voice Institute for Voice, Swallowing, and Airway Disorders, Downers Grove, Illinois, USA.
³¹ Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA.
³² Department of Otolaryngology-Head and Neck Surgery, The London Clinic, London, England.
³³ Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
³⁴ Department of Otolaryngology-Head and Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA.
³⁵ Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
³⁶ Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
³⁷ Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³⁸ Department of Otolaryngology-Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA.
³⁹ Department of Otolaryngology-Head and Neck Surgery, National University Hospital of Iceland, Reykjavik, Iceland, UK.
⁴⁰ Ear Nose and Throat, University of Sydney, Sydney, Australia.
⁴¹ Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, California, USA.
⁴² Department of Otolaryngology-Head and Neck Surgery, Ark-La-Tex Center for Voice, Airway & Swallowing, Shreveport, Louisiana, USA.
⁴³ Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, San Diego, California, USA.

PMID: 36939627
DOI: 10.1002/ohn.190

Abstract

The North American Airway Collaborative (NoAAC) previously published a 3-year multi-institutional prospective cohort study showing variation in treatment effectiveness between 3 primary surgical techniques for idiopathic subglottic stenosis (iSGS). In this report, we update these findings to include 5 years of data evaluating treatment effectiveness. Patients in the NoAAC cohort were re-enrolled for 2 additional years and followed using the prespecified published protocol. Consistent with prior data, prospective observation of 487 iSGS patients for 5 years showed treatment effectiveness differed by modality. Cricotracheal resection maintained the lowest rate of recurrent operation (5%), followed by endoscopic resection with adjuvant medical therapy (30%) and endoscopic dilation (50%). These data support the initial observations and continue to provide value to providers and patients navigating longitudinal decision-making. Level of evidence: 2-prospective cohort study.

Keywords: cricotracheal; dilation; dyspnea; endoscopic resection; iSGS; idiopathic; laryngology; subglottic stenosis; tracheal resection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Constriction, Pathologic
Humans
Laryngostenosis* / surgery
Prospective Studies
Retrospective Studies
Treatment Outcome