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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 3 - Laryngology/Broncho-Esophagology

Influence of Parity and Active Pregnancy on Disease Recurrence in Idiopathic Subglottic Stenosis

Monday, September 30, 2024
10:06 AM – 10:12 AM EDT
Location: MBCC, 224
Disclosure(s):
Andrew S. Awadallah, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Forrest W. Fearington, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Hawa M. Ali, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Idiopathic subglottic stenosis (iSGS) commonly affects premenopausal females with the capacity for pregnancy. We evaluated the impact of parity and active pregnancy on the severity and recurrence rate of iSGS.

Methods: A retrospective cohort study of premenopausal ( <40 years) iSGS patients undergoing dilation and laser wedge from 2002-2024 was conducted. Data collected included demographics, age at menstruation, history and number of pregnancies, and pregnancy status at recurrence time. Differences in recurrence rate between nulliparous and parous women were calculated using Wilcox rank-sum test.

Results: A total of 30 premenopausal patients with age range of 19-39 years were included. Most patients recurred at least once (77%), 80% had at least one full-term pregnancy, and 66% were in their 20s during the first pregnancy.

Parous women were more likely to recur at higher rates (n = 24, median number of recurrences = 3.5) compared to nulliparous women (n = 6, median recurrences = 0.5) (p-value = 0.03; medium follow-up time = 73 months). Of note, 50% of the nulliparous group did not recur following their initial iSGS compared to only 16% of parous women.

To explore the impact of active pregnancy on iSGS, we evaluated 10 patients who had disease exacerbations within a year of their pregnancy. Six patients were diagnosed with iSGS for the first time during an active pregnancy. Of the 10 patients, 5 required surgery during pregnancy, 3 required surgery within 3-4 months of delivery, and 2 required surgery within 5 months from delivery.

Conclusions: Parity and active pregnancy are associated with increased iSGS recurrence and increased severity of iSGS, possibly mediated by the dramatic rise in sex hormone levels during gestation. Given this, it is imperative for patients and providers to consider this association in the context of iSGS and family planning.

    Presenting Author(s)

  • Andrew S. Awadallah, BS

    Medical Student
    Mayo Clinic Alix School of Medicine
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Forrest W. Fearington, BS

    Medical Student
    Mayo Clinic Alix School of Medicine
    Rochester, Minnesota, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AB

    Andrew Bowen, MD

    Resident
    Mayo School of Graduate Medical Education (Rochester), United States

    Disclosure information not submitted.

    • Presenting Author(s)

  • Hawa M. Ali, MD

    Resident
    Mayo Clinic Department of Otolaryngology-Head and Neck Surgery
    Rochester, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • EE

    Eric Edell, MD

    Mayo Clinic, United States

    Disclosure information not submitted.

  • JW

    Joshua Weidermann, MD

    Mayo Clinic Department of Otolaryngology-Head and Neck Surgery, United States

    Disclosure information not submitted.

  • SB

    Semirra L. Bayan, MD

    Assistant Professor of Otolaryngology
    Mayo Clinic, USA

    Disclosure information not submitted.

    • Senior Author(s)

  • Dale C. Ekbom, MD

    Associate Professor of Otolaryngology, Director of Voice Disorders/Laryngology
    Mayo Clinic
    Rochester, MN, United States

    Disclosure information not submitted.