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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

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

Inflammatory Biomarkers as Predictors of Time to Recurrence in Idiopathic Subglottic Stenosis

Monday, October 13, 2025

9:36 AM - 9:42 AM EDT

Location: 138

Disclosure(s):

Kathleen M. Tibbetts, MD:

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

Introduction: Inflammatory biomarkers derived from a complete blood count (CBC) with differential have demonstrated prognostic value in inflammatory conditions. We hypothesize that these biomarkers correlate with recurrence of stenosis in patients with idiopathic subglottic stenosis (iSGS).

Methods: A multi-institutional retrospective chart review of patients treated for iSGS between 2017 and 2022 was performed. Data collected included demographics, number of and time interval between surgeries, and inflammatory biomarker levels obtained within 1 year of diagnosis. Inflammatory biomarkers included neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic-immune-inflammation index (SII), and systemic inflammation response index (SIRI). ROC curves and a machine learning model were used to identify validated cutoff values for inflammatory markers.

Results: A total of 109 patients (n=105 female) were identified, with an average age of 50.4 +/- 14.7 years. 51.4% required multiple procedures, and the median inter-procedural time was 392.5 (IQR 166 – 791.2) days. Stenosis greater than 2 years at diagnosis was associated with need for more than one procedure. PLR >130.8 was associated with performance of a second procedure (p=0.034) and increased total number of procedures (2.75 vs 1.91, p=0.037). SII>932 was significantly associated needing a second procedure (p=0.012), increased total procedures (2.64 vs 2.33, p=0.02), and decreased inter-procedural interval (452.7 days vs 861.7 days, p=0.026). On cox regression, PLR < 130.8 and SII < 932 were associated with decreased risk of disease recurrence, however not reaching statistical significance (p=0.081 and p=0.087, respectively).

Conclusions: Inflammatory biomarkers may correlate with disease severity in patients with iSGS. This could guide surveillance intervals and identify patients that would benefit from adjuvant treatment such as serial intralesional steroid injections. Future prospective studies are warranted to characterize the significance of these markers in patients with iSGS.

Presenting Author(s)

DB

Dylan G. Bertoni, MD

Fellow
Keck School of Medicine at University of Southern California
Los Angeles, CA, United States

Disclosure information not submitted.
KL

Kalena H. Liu, BS

Medical Student
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.

Co-Author(s)

KL

Kalena H. Liu, BS

Medical Student
Thomas Jefferson University
Philadelphia, PA, United States

Disclosure information not submitted.
Ryan K. Stepp, BS

Medical Student
USC Greenville Medical School
Greer, SC, United States

Disclosure information not submitted.
Kelsey Limage, BS

Research Fellow
Thomas Jefferson University
Washington, DC, United States

Disclosure information not submitted.
Joseph R. Spiegel, MD

Professor
Thomas Jefferson University Hospital
Philadelphia, PA, United States

Disclosure information not submitted.
James J. Daniero, MD

Associate Professor with Tenure
University of Virginia Department of Otolaryngology
Charlottesville, Virginia, United States

Disclosure information not submitted.

Senior Author(s)

Kathleen M. Tibbetts, MD

Associate Professor
Thomas Jefferson University
Philadelphia, PA, United States

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