2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

TABLE II. Main Study Parameters Revealing the Actual Starting %PEF, End %PEF, Peak %PEF, and Change in %PEF From the Treatments, Number, or Rounds, and the Number of Injections per Round

Follow-up, mo

No. of Rounds

No. of Injections/Round Surgery

D %PEF

No.

First %PEF Last %PEF Peak %PEF

Comment

1

61

28% 82% 86% 54% 1

2

No

2

20

100% 104% 106% 4% 1

3

No

3 4

64 16

89% 97% 97% 8% 2 50% 57% 81% 7% 1

12

No No

7

Fell below 80%, lost to follow-up

5

61

55% 98% 104% 43% 1

4

No

6 7

10 47

56% 93% 93% 37% 1 68% 76% 99% 8% 2

7 4

No

Yes

Now first time below 80%

8

54

38% 93% 100% 55% 3

7

Yes

9

53 22

70% 105% 116% 35% 2 35% 110% 120% 75% 1

7

Yes Yes

10

10

11

25

45% 82% 85% 37% 5

5

Yes

Keeps falling below 80%

12

16

54% 111% 111% 57% 1

6

Yes

13

12

60% 98% 104% 38% 1

4

Yes

Three subjects either fell below the 80% %PEF threshold, subjects 4 and 7, and subject 11, who had been the most difficult to manage (despite her most recent %PEF score of 82%). She underwent five rounds of treatment and had a “picket-fence” appearance to her %PEF over time. Her %PEF values are graphed separately in Figure 6. PEF 5 peak expiratory flow.

improved airway caliber in a manner that was statistically equal objectively to the improvement achieved with OR treatment. Of course, we feel there is a role for surgery in

combination with SILSI when subjects have severe stenosis or for those who wish to have quick relief of their dyspnea, followed by full-course SILSI to maintain those results.

Fig. 6. Scatterplot of %PEF for subject 11, a member of group 2, including detailed charting of subject 11’s %PEF values and the proce- dures performed to improve her breathing. She underwent a total of two surgical interventions in the operating room and three in-office bal- loon dilations. She was unable to maintain elevated and stable %PEF values, despite five rounds of treatment that included five injections per round (25 total), two surgeries with debridement, steroid injection and balloon dilation in the operating room, and three awake balloon dilations. Solid markers indicate steroid injections, whereas open markers indicate pulmonary function test results without treatment. PEF 5 peak expiratory flow. [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]

Laryngoscope 00: Month 2017

Franco et al.: Intralesional Steroid Injections for iSGS

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