Long-term results of endoscopic balloon dilatation of subglottic stenosis – a case series

Introduction Subglottic stenosis is a rare disease that is often diagnosed late due to similar manifestations by obstructive pulmonary disease. Besides idiopathic cases, the most common causes are iatrogenic lesions, laryngeal trauma or underlying inflammatory diseases.

Materials and Methods To evaluate the long-term therapeutic effect of endoscopic balloon dilatation with or without laser therapy, n= 106 patients with subglottic stenosis treated at the ENT department of the University Hospital of Wuerzburg from 2011 to 2022 were retrospectively reviewed. Clinical symptoms were evaluated at initial presentation and during follow-up visits. Endoscopic findings were classified according to the Myer-Cotton classification. Symptom-free intervals were determined between interventions and since the last intervention. In addition, it was reviewed whether therapy had to be escalated by tracheal resection.

Results The main symptoms were progressive exertional dyspnea and inspiratory stridor. The symptoms were sufficiently reduced by balloon dilatation in 92,5 %. With increasing time, the intervals between two interventions were extended. In 8 cases, therapy had to be escalated by tracheal resection. The symptom-free interval since the last intervention averaged 3 years. Complications were rare, occasionally postoperative swelling or postoperative bleeding occurred, especially after laser surgical therapy.

Discussion Endoscopic Balloon dilatation is a therapeutic approach of subglottic stenosis with a low complication rate. The Intervention can be repeated easily in case of recurrence. In many cases, a complex tracheal resection can be avoided.

Publication History

Article published online:
12 May 2023