Voice-Related Quality of Life Is Associated with Postoperative Change in Subglottic Stenosis

Laryngoscope. 2021 Feb;131(2):360-365. doi: 10.1002/lary.29156. Epub 2020 Oct 7.

Abstract

Objectives: To characterize the impact of subglottic stenosis (SGS) on voice-related quality of life (V-RQOL) and quantify the effect of treatment on voice outcomes.

Study design: Case series.

Methods: Retrospective review of SGS patients treated from 1996 to 2018 at a single institution to assess for 1) V-RQOL association with individual patient cumulative treatment number and 2) V-RQOL correlation with treatment type, time between treatments, and degree of stenosis. Analysis included both parametric and nonparametric statistical comparison across treatment types and multivariable and univariate linear regression.

Results: Sixty-one patients, predominantly white (93%) and female (93%), were included. Etiology of SGS included idiopathic (61%), iatrogenic (16%), granulomatosis with polyangiitis (16%), and other (7%). The plurality of patients had four or more treatments (44%), with the remainder having one (28%), two (13%), or three treatments (15%). Analysis of change between pre- and postoperative V-RQOL scores was completed for 130 treatments. These included dilation with laser incision (52%), in-office injection (34%), dilation without division (8%), cricotracheal resection (1%), and all other treatment (8%). For every 10% improvement in airway caliber postoperatively, there was a 1.3-point improvement in calculated V-RQOL (r = 0.27, P = .02). After adjustment for treatment type, age, sex, and SGS etiology, this association held (beta = 1.5, P = .02). Change in V-RQOL was not associated with treatment type, treatment number, or time between treatments.

Conclusion: Patients with subglottic stenosis who have greater degree of change in airway caliber experience greater improvement in V-RQOL scores following treatment. V-RQOL scores are not associated with treatment type or time between individual treatments.

Level of evidence: 4 Laryngoscope, 131:360-365, 2021.

Keywords: Subglottic stenosis, dysphonia, voice-related quality of life, V-RQOL.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Laryngostenosis / physiopathology
  • Laryngostenosis / psychology*
  • Laryngostenosis / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / psychology*
  • Postoperative Period
  • Quality of Life*
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome
  • Voice Disorders / etiology
  • Voice Disorders / physiopathology
  • Voice Disorders / psychology*
  • Voice Quality*