Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects

Matthew R Hoffman; David O Francis; Johnny P Mai; Seth H Dailey

doi:10.1177/0003489419889066

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Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects

Journal article

Peer reviewed

Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects

Matthew R Hoffman, David O Francis, Johnny P Mai and Seth H Dailey

Annals of otology, rhinology & laryngology, Vol.129(4), pp.361-368

04/2020

DOI: 10.1177/0003489419889066

PMID: 31747777

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Abstract

Office-based steroid injection has shown promise for idiopathic subglottic stenosis (iSGS). It is important to understand safety and patient-lived experience. We report patient experience related to airway restriction, voice, and side effects. Sixteen patients (51 ± 14 years) with mild-moderate (20-50%) stenosis undergoing office-based transnasal steroid injections were included; fourteen had prior operations. Patients typically underwent three injections, 1 month apart, followed by transnasal tracheoscopy 1 month later to evaluate outcome; number of injections can vary based on disease severity and response. Outcomes were Dyspnea Index (DI), Modified Medical Research Council (MMRC) dyspnea scale, voice handicap index-10 (VHI-10), and degree of stenosis (estimated from procedural video). At each visit, patients were queried about post-injection airway restriction and side effects. Paired -tests compared values at baseline versus follow-up tracheoscopy. DI decreased ( = 3.938, = 0.0013), as did MMRC ( = 2.179, = 0.0457). There was no change in VHI-10 ( = 1.354; = 0.1957) scores. Airway stenosis decreased ( = 4.331; = 0.0006); this was not correlated with change in DI ( = 0.267, = 0.318). Side effects included airway restriction lasting <48 hours (n = 5), cough (n = 3), and nasal pain (n = 2). Steroid injections improved upper airway symptoms. Side effects were mild and transient. Improvement in DI did not correlate with percent stenosis.

Adult

Ambulatory Care - methods

Disability Evaluation

Dyspnea - etiology

Dyspnea - therapy

Female

Glucocorticoids - administration & dosage

Humans

Injections, Intralesional - adverse effects

Injections, Intralesional - methods

Laryngoscopy - methods

Laryngostenosis - complications

Laryngostenosis - physiopathology

Laryngostenosis - psychology

Laryngostenosis - therapy

Male

Middle Aged

Severity of Illness Index

Treatment Outcome

Voice Disorders - diagnosis

Voice Disorders - etiology

Voice Disorders - therapy

Details

Title: Subtitle: Office-Based Steroid Injections for Idiopathic Subglottic Stenosis: Patient-Reported Outcomes, Effect on Stenosis, and Side Effects
Creators: Matthew R Hoffman - University of Wisconsin–Madison
David O Francis - University of Wisconsin–Madison
Johnny P Mai - University of Wisconsin–Madison
Seth H Dailey - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Annals of otology, rhinology & laryngology, Vol.129(4), pp.361-368
DOI: 10.1177/0003489419889066
PMID: 31747777
ISSN: 0003-4894
eISSN: 1943-572X
Language: English
Date published: 04/2020
Academic Unit: Otolaryngology
Record Identifier: 9984366287702771

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