Subglottic Stenosis: Retrospective Analysis and Proposal for Standard Reporting System

Abstract

A retrospective analysis was undertaken reviewing management of 67 patients treated for subglottic stenosis (SGS) at the Children's Hospital National Medical Center (CHNMC) between 1980 and 1985. Forty-seven (90%) of the patients were followed for at least 18 months from the time diagnosis was made. Twenty-three (66%) of the patients followed for at least 18 months were successfully decannulated or had an adequate airway without tracheotomy. To compare efficacy of management of SGS at the CHNMC with management outcomes previously reported, a review of medical literature was undertaken and data from the most significant reports on management of SGS were collated and tabulated. Since analysis of published reports did not yield a consensus regarding optimal methods for management, and statistics in many published reports were absent or unclear, authors of the previously published reports were contacted personally by means of a letter and survey questionnaire. Results of the survey show that many authors have not performed a statistical review of their case data to determine relative efficacy of different surgical procedures. Thus, retrospective review of cases managed at the CHNMC as well as information obtained from leading experts in management of SGS indicate that there is no single optimal procedure or technique for management of all cases of SGS. Further, the way in which surgical procedures for management of SGS are being reported makes difficult the process of meaningfully comparing results reported by different surgeons. a reporting system is proposed that uses specific terms and objective parameters.