Balloon dilation of subglottic stenosis especially in granulomatosis with polyangiitis

Subglottic stenosis (SGS) are narrowings in the area below the vocal folds and cause symptoms such as dyspnea and stridor. These narrowings can be found in granulomatosis with polyangiitis (GPA), post-traumatic or idiopathic.

In this study, the therapeutic procedure of balloon dilation was investigated. For this purpose a cohort of patients (n=14, 7 idiopathic stenosis, 7 GPA stenosis) was prospectively evaluated. The evaluation included pulmonary function tests, laryngoscopy and two questionnaires ("Clinical Chronic Obstructive Pulmonary Disease Questionnaire", "modified Medical Research Council Dyspnoea Scale") on the respiratory situation. These measurements took place before the ballon dilation and 3, 6 and 12 months afterwards. In addition, the number of interventions required , the degree of stenosis according to Myer Cotton and measured in millimeters, as well as complications were documented for each patient. During the study period, a total of 30 interventions were performed. In four patients, only one treatment was necessary. The evaluation of the questionnaires showed that the state of health improved in all patients three months after intervention had been carried out. Lung function tests showed an improvement in respiratory status 3-6 months after intervention. The degree of stenosis measured intraoperatively in millimeters showed that patients with a stenosis diameter below D=4 mm needed only one intervention. Patients with a larger stenosis diameter required multiple treatments. At the current stage of the study, balloon dilation seems to be a successful method for the treatment of subglottic stenosis leading to an improvement in respiration. At midterm follow-up after one year, the method was successful in 4 of 14 patients.

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Artikel online veröffentlicht:
24. Mai 2022