Eur Arch Otorhinolaryngol. 2025 Nov 1. doi: 10.1007/s00405-025-09547-x. Online ahead of print.
ABSTRACT
OBJECTIVE: We conducted this systematic review and meta-analysis to investigate the efficacy and safety of the use of serial intralesional steroid injection (SILSI) in patients with subglottic stenosis (SGS).
DATA SOURCES: PubMed, Web of Science, and Scopus databases, from inception until December 2024.
REVIEW METHODS: Database search used the following keywords: “Subglottic stenosis” AND “Intralesional.” The meta-analysis pooled the mean difference (MD) and standardized mean difference (SMD) for outcomes measured on different scales, based on pre-operative and post-operative values, with 95% confidence interval (CI). For categorical variables, we used Open MetaAnalyst software to calculate the rate of different outcomes and the effect estimates. Heterogeneity was assessed using the I2 statistic.
RESULTS: The use of SILSI in SGS patients increases the surgery-free survival duration with a MD = 395.27 days (95% CI: 166.14, 624.39, p = 0.0007), I2 = 81%, p = 0.0003. Additionally, the use of SILSI was associated with an increase in peak expiratory flow (PEF: MD = 30.6; 95% CI: 16.1, 45.1; p < 0.0001), I2 = 100%, p < 0.00001. The effect estimates for categorical outcomes were success rate (0.92; 95% CI: 0.872, 0.969), adverse events (0.257; 95% CI: -0.043, 0.556), and recurrence rate (0.451; 95% CI: -0.058, 0.960).
CONCLUSION: SILSI has shown a high success rate, extended surgery-free survival, and improved PEF, with a relatively low recurrence rate and minimal risk of adverse events. Given this high efficacy and favorable safety profile, SILSI is recommended for use in SGS.
PMID:41176560 | DOI:10.1007/s00405-025-09547-x
