Voice Outcomes After Endoscopic Intervention in Subglottic Stenosis: A Systematic Review.

Abstract

Endoscopic intervention is a common approach to improve airway patency and breathing outcomes in patients with subglottic stenosis, but effects on voice are underreported. This review aims to assess the current evidence on how endoscopic intervention influences voice outcomes in individuals with subglottic stenosis. A systematic review was conducted by searching PubMed and Cochrane for studies published through June 2025 on voice outcomes following endoscopic airway surgery for subglottic stenosis. Studies were reviewed by three authors, and data related to patient-reported outcome measures, auditory-perceptual characteristics, and acoustic and aerodynamic analysis were extracted and analyzed. A total of 2351 abstracts were screened, with 8 meeting inclusion to be included in the final analysis. All studies employed observational designs, primarily retrospective chart reviews and prospective cohort studies, with notable heterogeneity in outcome measures. Among 829 subjects, the mean age was 50.9 years, and 96.5% identified as female. Patient-reported outcome measures (VHI, VHI-10, V-RQOL, and GFI) demonstrated improvement of inconsistent statistical significance. Auditory-perceptual ratings assessed using GRBAS or CAPE-V scales were generally mild in dysphonia severity preprocedure and were generally preserved postprocedure. Acoustic measures of perturbation and aerodynamic laryngeal resistance suggested improvement postprocedure. Endoscopic dilation shows potential in improving voice outcomes, though definitive conclusions are hindered by current evidence limitations in a heterogeneous disease process. Future research should focus on utilizing comprehensive, validated voice outcomes, controlling for surgical technique variability, and strengthening methodological rigor to support more robust analysis and facilitate patient counseling.