Subglottic Stenosis

The management of idiopathic subglottic stenosis (iSGS) has changed rapidly over the last decade, as researchers have learned more about how to control disease’s inflammatory pathophysiology. It can be challenging to appropriately tailor existing treatment options to patient preferences.

Review “A Look at the Latest Research on Subglottic Stenosis,” published in the August 2020 issue of ENTtoday, before you take this quiz.

Which of the following should ENTs consider when discussing treatment choices with their patients?

A. Open surgery carries more significant risks compared to endoscopic procedures, including potential postoperative voice changes. However, unlike traditional endoscopic options, it provides an opportunity for a long-term cure.

B. Endoscopic dilation is less invasive than open surgery or endoscopic resection with medical therapy. However, of the three approaches it appears to carry the highest risk of recurrence, necessitating more repeat procedures.

C. Serial intralesional steroid injections might be used to delay or avoid surgery in some patients with iSGS.

D. New minimally invasive endoscopic surgical approaches can remove selected affected areas of mucosa and use epithelial reconstitution with dermal or buccal grafts. This may allow for more long-lasting improvements in patients’ airways without the increased morbidity of an open resection.

E. All of the above are reasonable factors to consider.

Question by Ruth Jessen Hickman, MD