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The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology

Published online by Cambridge University Press:  27 April 2016

M Wierzbicka ,
M Tokarski ,
M Puszczewicz  and
W Szyfter
M Wierzbicka*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
M Tokarski
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
M Puszczewicz
Affiliation:
Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Poland
W Szyfter
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
*
Address for correspondence: Dr Małgorzata Wierzbicka, Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Przybyszewskiego Str. 49, 60-356 Poznań, Poland E-mail: otosk2@ump.edu.pl
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Abstract

Objective:

To determine the long-term efficacy of submucosal corticosteroid injection plus dilatation for subglottic stenosis as a single modality treatment in granulomatosis with polyangiitis and relapsing polychondritis, as compared with idiopathic subglottic stenosis and traumatic subglottic stenosis.

Method:

Patients who underwent dilatation for autoimmune causes were identified. Corticosteroid injection into the submucosa of a stenotic segment was followed by serial dilatation. Definitive improvement was defined as good airway patency for more than 24 months with no further procedures needed. Clinical, demographic and procedural data were recorded.

Results:

Patients (n = 45) were divided into three subglottic stenosis groups: traumatic (n = 24), idiopathic (n = 9) and autoimmune (n = 12). Patients were treated with dilatations, with a median follow-up time of 76 months. Six patients were tracheostomy-dependent. There were no statistical differences in the number of final improvements between autoimmune, idiopathic and traumatic groups, with values of 75, 56 and 71 per cent, respectively. There was no statistical difference between granulomatosis with polyangiitis plus relapsing polychondritis and idiopathic subglottic stenosis in terms of decannulation rates.

Conclusion:

Granulomatosis with polyangiitis and relapsing polychondritis patients have better improvement rates than patients with other subglottic stenosis types.

Keywords

Acquired Subglottic StenosisRelapsing PolychondritisGranulomatosis With PolyangiitisDilatationIntralesional Injections
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 674 - 679
Copyright
Copyright © JLO (1984) Limited 2016 

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