In-Office Steroid Injections for Idiopathic Subglottic Stenosis: A Systematic Review.

Abstract

To critically evaluate clinical and voice-related outcomes of in-office serial intralesional steroid injection (SILSI) in adults diagnosed with idiopathic subglottic stenosis (iSGS). MEDLINE, Embase, CINAHL Ultimate, CENTRAL, ClinicalTrials.gov. A systematic search of databases was conducted from inception through April 5, 2025. Studies eligible for inclusion must have reported on adult SILSI recipients undergoing management of iSGS. Articles were independently screened and reviewed by two authors for treatment variables including steroid protocol, clinical outcomes, respiratory function, vocal outcomes, and complications. Of 383 studies identified, 14 met inclusion criteria (n = 371). Triamcinolone was the most commonly used agent in 10 studies. Steroid dosage, number of treatment sessions, and injection interval varied widely across studies. Improvements in surgery-free interval, peak expiratory flow, dyspnea index, degree of stenosis, and voice-related outcomes were observed in several studies. No major complications were reported in the included studies. Current evidence suggests SILSI represents a promising adjunctive therapy in the treatment of iSGS, with improvement noted across several measures. However, significant variability in steroid treatment regimens and inconsistent reporting of outcomes complicate interpretations of efficacy.