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


METHODS
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.


CONCLUSIONS
Granulomatosis with polyangiitis and relapsing polychondritis patients have better improvement rates than patients with other subglottic stenosis types.
Department of Otolaryngology, Head and Neck Surgery,Poznan University of Medical Sciences,Poland.
M
M
Wierzbicka
Department of Otolaryngology, Head and Neck Surgery,Poznan University of Medical Sciences,Poland.
M
M
Tokarski
Department of Rheumatology and Internal Medicine,Poznan University of Medical Sciences,Poland.
M
M
Puszczewicz
Department of Otolaryngology, Head and Neck Surgery,Poznan University of Medical Sciences,Poland.
W
W
Szyfter
D000328:Adult; D004106:Dilatation / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006801:Humans; D015552:Injections, Intralesional; D007829:Laryngostenosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000150:complications; D014139:Tracheostomy; D014947:Wounds and Injuries / Q000150:complications
D005938:Glucocorticoids; D008775:Methylprednisolone
Acquired Subglottic Stenosis; Dilatation; Granulomatosis With Polyangiitis; Intralesional Injections; Relapsing Polychondritis