Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Laryngology/Broncho-Esophagology

Impact of BMI on Dyspnea and Intervention in BLVC Immobility

Tuesday, October 3, 2023
3:54 PM - 4:00 PM East Coast USA Time
Location: 106BC

    Presenting Author(s)

  • SE

    Samer T. Elsamna, MD

    Resident Physician
    Department of Otolaryngology – Head & Neck Surgery, University of South Florida, Tampa, Florida, USA
    Tampa, FL, United States

    • Co-Author(s)

  • Matthew E. Lin, BS

    Medical Student
    Keck School of Medicine of USC
    Alhambra, CA, United States

  • Michael M. Johns III, III, MD

    Professor
    Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine, University of Southern California
    Los Angeles, California, United States

  • Michael M. Johns III, III, MD

    Professor
    Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine, University of Southern California
    Los Angeles, California, United States

    • Senior Author(s)

  • yael Bensoussan, MD

    Assistant Professor
    Department of Otolaryngology – Head & Neck Surgery, University of South Florida, Tampa, Florida, USA
    Tampa, FL, United States

Disclosure(s):
Matthew E. Lin, BS: No relevant relationships to disclose.
Introduction: Bilateral vocal fold paralysis (BLVFP) and posterior glottic stenosis (PGS) are perilous conditions that can lead to various levels of shortness of breath, stridor, and possibly surgical airway intervention. Although increased body mass index (BMI) can be associated with restrictive breathing patterns in patients with normal upper airways, it is unclear how BMI impacts dyspnea and need for surgery in patients with BLVFP or PGS.

Methods: Retrospective cohort chart review of patients presenting with BLVFP or PGS at three academic institutions. Demographic data, BMI, Dyspnea Index (DI), presence of tracheostomy and surgical intervention (dilation, transverse cordotomy and arytenoidectomy) were collected. Linear regressions were performed to assess continuous outcomes, while Mann-Whitney U-test was utilized to assess categorical outcomes.

Results: Among the 121-patient cohort, 49 presented with BLVFP and 62 with PGS. Previous neck surgery was the most common cause of BLVF immobility (42.34%). 44.14% of patients received a tracheostomy. In a multivariate linear regression model adjusting for confounders, increased BMI was significantly associated with increased DI in the entire cohort (R: 0.28, p=0.024). Increased BMI was also associated with need for surgery (p=0.016) in the overall cohort. When stratifying for BLVFP and PGS, this association was only statistically significant for PGS patients (p=0.014), although a positive trend was seen for BLVFP. No significant association was identified between BMI and need for tracheostomy.

Conclusions: Increased BMI seems to be correlated to an increase in dyspnea symptoms and need for surgical intervention in patients with bilateral vocal fold immobility. Weight-loss related counseling could be beneficial regarding symptoms management in that patient population.