Idiopathic Subglottic Stenosis Is a Reflux Mediated Disease

Is there evidence of extraesophageal reflux (EER) in idiopathic subglottic stenosis (iSGS)?

Background: Although a subset is related to identifiable trauma, many stenoses in the upper airway are deemed idiopathic. Theories involving the etiology of iSGS have centered around two possibilities: that an occult condition leads to mucosal scarring of the cricotracheal junction and that it relates to a female gender predilection. Proposed causes have included collagen-vascular disease, hormonal alteration, occult trauma and EER. However, studies have ruled out causes such as Wegener’s granulomatosis and hormonal alteration. Interest in EER has continued as the significance of EER to inflammatory lesions of the upper aerodigestive tract has been established. Pepsin assay has been used to identify evidence of gastric refluxate and as a reliable marker for EER.

Study Design: Case-control study.