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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 3 - Laryngology/Broncho-Esophagology

Hormone Replacement Therapy and Disease Outcomes in Post-Menopausal Patients with Idiopathic Subglottic Stenosis

Monday, October 13, 2025

9:48 AM - 9:54 AM EDT

Location: 138

Disclosure(s):

Andrew Salib Awadallah, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Idiopathic subglottic stenosis (iSGS) primarily affects peri- and post-menopausal females. During menopause, many patients consider hormone replacement therapy (HRT), but its potential hormonal influence on iSGS progression raises concerns among providers. Limited data exists to guide HRT use in this population. This study aimed to evaluate whether systemic HRT affects recurrence rates or time to first recurrence in post-menopausal iSGS patients.

Methods: This retrospective study at a tertiary academic center included peri- and post-menopausal iSGS patients (>50 years old). Patients using systemic HRT (e.g., estrogen pills, progesterone pills, combination tablets, or estrogen patches) prior to or during their first surgery were assigned to the “HRT” group. Patients who never used HRT comprised the “Never-HRT” group. Recurrence rates were analyzed using Mann-Whitney tests, and Kaplan-Meier analysis estimated time to first recurrence.

Results: The cohort included 110 Never-HRT patients (median age 58) and 14 HRT patients (median age 59). Patients using HRT were 2.85 times more likely to experience a first recurrence compared to those not using HRT (CI [2.00-4.08], p < 0.0001). No significant differences were observed in the overall number of recurrences between groups (median = 2; p = 0.8493). Kaplan-Meier analysis revealed no significant difference in time to first recurrence between groups (p = 0.7242).

Conclusions: Hormone replacement therapy at the time of initial diagnosis appears to be associated with a higher likelihood of first recurrence in iSGS patients. These findings may help inform discussions between physicians and patients regarding the timing of HRT initiation. Future research will focus on evaluating the impact of HRT initiation after initial surgery on disease outcomes.

Presenting Author(s)

Andrew Salib Awadallah, BS

Medical Student
Mayo Clinic Alix School of Medicine
Rochester, MN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

FF

Forrest W. Fearington, BS

Medical Student
Mayo Clinic Alix School of Medicine
Rochester, MN, United States

Disclosure information not submitted.
LY

Li Yan, PhD, M.S.

Senior Biostatistician
Mayo Clinic
Rochester, MN, United States

Disclosure information not submitted.
AB

Andrew Bowen, MD, M.S.

Resident
Metrohealth Medical Center, United States

Disclosure information not submitted.
Ali M. Hawa, MD

Dr
Mayo School of Graduate Medical Education (Rochester)
Rochester, Minnesota, United States

Disclosure information not submitted.
EE

Eric Edell, MD

Mayo Clinic, United States

Disclosure information not submitted.
MK

Matthew J. Koster, MD

Associate Professor of Medicine
Mayo Clinic
Rochester, MN, United States

Disclosure information not submitted.
AR

Amy L. Rutt, DO

Associate Professor of Otolaryngology Head and Neck Surgery, Laryngologist
Mayo Clinic Jacksonville, FL
Atlantic Beach, FL, United States

Disclosure information not submitted.
Semirra L. Bayan, MD

MD
Mayo Clinic
Rochester, Minnesota, United States

Disclosure information not submitted.

Senior Author(s)

Dale C. Ekbom, MD

Professor of Otolaryngology/Head and Neck Surgery, Director of Voice Disorders/Laryngology
Mayo Clinic
Rochester, MN, United States

Disclosure information not submitted.