Source: Annual Congress 2009 - How to deal with tracheal stenosis

Abstract

Rationale: Subglottic stenosis (SGS) is a narrowing of the airway below the level of the vocal cords. It remains unclear why some individuals develop SGS, but gastroesophageal reflux disease (GERD) may be a contributing factor.
Objective: To determine the prevalence of GERD in adult patients with SGS compared with the general population.
Methods: Prospective cohort study of 10 adult SGS patients (8 females & 2 males) who underwent GERD testing by pH probe (7 patients) or upper endoscopy (3 patients). Anti-reflux therapy was stopped 7 days prior to testing. A two-sided exact binomial test was used for statistical analysis of prevalence data.
Results: All patients were non-smokers and the mean age was 52. The etiology of stenosis was idiopathic (6), post-intubation (1), Wegener‘s granulomatosis (1), relapsing polychondritis (1), and radiation (1). 7 of 10 patients were GERD (+) in the SGS population yielding a prevalence of 70% (prevalence in the western world 20%, p=0.002). The mean DeMeester score of GERD (+) and GERD (-) patients was 32.5 and 8.3, respectively (range 4.3-49.7). In 57% of patients, there was poor symptom correlation indicating that reflux may be silent. Concurrent smoking was not a confounding variable
Conclusion: GERD seems more prevalent in patients with SGS than in the general population and may be silent in this population.

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D. Nataraj, M. Kent, S. Gangadharan, M. Delamp, A. Majid, G. Michaud, F. Herth, A. Lembo, A. Ernst (Boston, United States Of America). Gastroesophageal reflux disease and subglottic stenosis. Eur Respir J 2009; 34: Suppl. 53, 4239

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