(309) The Impact of Menopausal Status on Idiopathic Subglottic Stenosis

Introduction: Idiopathic subglottic stenosis occurs almost exclusively in females, which suggests a hormonal link. Our study evaluates disease characteristics in pre- and post-menopausal women who have high and low estrogen, respectively.

Methods: Our study controlled for prior airway surgery by only enrolling patients with idiopathic subglottic stenosis (iSGS) who underwent their first laser wedge excision (LWE) between 2002-2021. In this retrospective chart review, data pertaining to patient menopausal status, median time to first recurrence, and disease clinical features were collected and analyzed.

Results: 100 female patients with an age range of 19-70 years were identified. The proportion of patients identified as pre-, peri-, and post-menopausal (and their average age) were n=20 (37 years), n=8 (43 years), n=72 (55 years), respectively. All groups had a median full-term pregnancy of 2. There was no difference in the percentage of patients who received a tracheostomy or had an open surgery. Notably, the median time to recurrence (MTR) for the first recurrence was 24, 27.5, and 36 months for the pre-, peri-, and post-menopausal groups, respectively.

Conclusions: Our data suggests that menopause leads to a longer time to first recurrence (36 months vs 24 months) in a large cohort of idiopathic SGS patients after controlling for prior airway surgery. This study provides evidence of the role of menopause in disease progression and the role of estrogen in iSGS’s disproportionate impact on females. Additional analyses are underway to evaluate recurrence rates and control for other variables such as triple therapy compliance and estrogen replacement therapy.