Spray cryotherapy for the treatment of glottic and subglottic stenosis

Abstract

OBJECTIVES/HYPOTHESIS: Functional partial occlusion of the glottic and subglottic areas by stenosis and strictures is challenging to manage despite a variety of surgical and endoluminal approaches that are prone to complications and inconsistent outcomes. We report here the first three human cases of glottic and subglottic narrowing treated with spray cryotherapy alone or in combination with balloon dilation. STUDY DESIGN: Institutional review board-approved clinical human trial. METHODS: A 42-year-old female with idiopathic subglottic strictures, a 74-year-old female with glottic strictures and vocal cord stenosis following neck radiation, and a 33-year-old female with strictures from a previous tracheal stent were treated by four cycles of a 5-second cryotherapy spray alone or with balloon dilation. The effects of treatment were observed up to 6 months, 12 weeks, and 9 months, respectively. RESULTS: In all cases, patency of the stenosed areas was achieved with minimal bleeding and at least some degree of normalization of the glottic and subglottic mucosa. Airway patency and laryngeal functions were restored without complications. CONCLUSIONS: The use of spray cryotherapy alone or in conjunction with balloon dilation is a promising and effective therapeutic approach to treating glottic and subglottic narrowing.