Abstract
Problem: New technique for treating subglottic stenosis.
Methods: A blinded, randomized, controlled study was performed using a dog model of subglottic stenosis. Standardized methods were used to induce and dilate the stenoses. When they required dilation, dogs were randomized to a brachytherapy arm, which delivered 20 gray to the subglottis, and a control arm. Dogs were followed for 21 days after randomization. Data points included the number of subsequent airway dilations, final airway size, as well as histological and growth factor differences between the groups. All data were gathered in a blinded fashion. The Rank Sum test was used to evaluate clinical results.
Results: There was a trend for increased airway size in the radiated group with an average size of 5.5 ET tube versus 4.6 for the control group. Also, one dog required redilation from the radiated group while 2 dogs from the control group required redilation. These trends did not reach statistical significance when using the Wilcoxon Rank Sum test.
Conclusion: There were trends for improved airway size in the brachytherapy arm. Statisitcal significance was not reached owing to small numbers or restenosis overall.
Significance: This is the first controlled study looking at use of radiation as a potential treatment for subglottic stenosis. Brachytherapy could be a helpful adjuvant treatment for subglottic stenosis in adults.
Support: Nucletron Corporation provided a partial grant and free equipment for this experiment.
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