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Laryngology/Broncho-Esophagology

Age in Glottic vs Multilevel Airway Stenosis: A Multi-institutional Review

Sunday, October 1, 2023
3:57 PM - 4:03 PM East Coast USA Time
Location: 106BC

    Presenting Author(s)

  • Chanticha Laohakittikul, MD

    Clinical Instructor
    Otorhinolaryngology Department, Faculty of Medicine, Khon Kaen University, Thailand
    San Francisco, CA, United States

    • Co-Author(s)

  • IK

    Inderpreet Kaur Khalsa, MS

    Medical Student
    School of Medicine, University of California–San Francisco
    Turlock, CA, USA

  • Shambavi J. Rao, MD

    Resident Physician
    Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
    Columbus, OH, United States

  • Lyndsay L. Madden, DO

    Associate Professor of Otolaryngology-Head and Neck Surgery
    Wake Forest University School of Medicine
    Winston Salem, NC, United States

  • Daniel J. Cates, MD

    Associate Professor
    University of California, San Diego
    La Jolla, CA, United States

    • Senior Author(s)

  • VY

    VyVy N. Young, MD

    Associate Professor
    UCSF Voice and Swallowing Center
    San Francisco, California, United States

Disclosure(s):
Chanticha Laohakittikul, MD: No relevant relationships to disclose.
Shambavi J. Rao, MD: No relevant relationships to disclose.
Lyndsay L. Madden, DO: No relevant relationships to disclose.
VyVy N. Young, MD: No relevant relationships to disclose.
Introduction: Airway restriction affects all ages, but impact of age on treatment and outcomes is unknown. This study analyzed younger ( < 65 years) and geriatric (≥65 years) adults with posterior glottic stenosis (PGS), multi-level airway stenosis (MLAS), and bilateral vocal fold paralysis (BVFP).

Methods: A retrospective analysis of airway stenosis patients at three tertiary medical centers (2016-2021) was performed. Demographics, etiology, stenosis type, treatment and outcomes, and patient-reported outcome measures (PROMs) were compared between younger and geriatric cohorts. Analyses included chi-squared/Fisher’s exact and Mann-Whitney tests.

Results: 158 patients [96 younger (30 PGS, 29 MLAS, 37 BVFP) and 62 geriatric (24 PGS, 9 MLAS, 29 BVFP)] were studied. Age differences were not significant for stenosis type (p=0.079), gender (p=0.990), tracheostomy (70% (younger) vs. 66% (geriatric), p=0.629), or overall decannulation success (40% vs. 24%, p=0.091). Younger BVFP patients were more likely to decannulate than geriatric (50% vs. 12%, p=0.017). Older patients underwent fewer surgeries (median 1 vs. 3, p=0.003). Prior radiation was more common in geriatric patients (26% vs. 10%, p=0.016), but other comorbidities were similar between age groups (p>0.05). Median PROMs at latest follow-up were comparable between age groups (p>0.05); however, change in Voice Handicap Index-10 following intervention for BVFP was significantly greater for younger patients (median -6 vs. -0.5, p=0.02).

Conclusions: Younger adults underwent more surgeries but tracheostomy rate, decannulation rate, overall comorbidities, and PROMs were comparable between age groups. Age does not negatively impact treatment outcomes for patients with airway stenosis and should not be a deterrent in treatment decision-making.