Laryngology

Using a Remote Peak Flow Meter to Predict Severity of Subglottic Stenosis 

Park M, Tie K, Davis H, Hall J, Buckmire RA, Shah RN. Can the Remote Use of a Peak Flow Meter Predict Severity of Subglottic Stenosis and Surgical Timing?. Laryngoscope. 2023;133(3):628-633. [Article Link] 

Just go with the flow

Subglottic stenosis (SGS) is due to a narrowing of the airway between the vocal cords and trachea; common causes are intubation, infection, and trauma. This prospective study of thirty-five SGS patients aimed to determine the relationship between patient reported peak flow meter (PFM) measurements with pulmonary function testing (PFT) and Dyspnea Index (DI) questionnaire scores in order to determine if SGS severity could be monitored remotely. Pre- and post-operative data were compared for patients who underwent surgery for SGS (n=16). The patient reported PFM values revealed a “strong positive correlation with PEVR and FEV1 (r=0.78 and r=0.70 respectively).” Receiver operating characteristics curves (calculated for PFTs, PFM, and DI scores to predict the need for operative intervention) showed PFM was the most specific (79%) and DI was the most sensitive (88%). Results indicate PFMs, alongside clinical evaluation and DI, may serve as an affordable, convenient, and sensitive way to monitor SGS disease severity and predict need for surgical intervention. However, the study was limited by a small sample size, and more data is needed to support the ability to follow SGS remotely which can offer increased access to care and decreased office visits.

Amina Anwar’s Takeaway: Patient’s with SGS may experience recurrence and require multiple treatments. The possibility of a remote option to assess condition and need for surgery would likely be an attractive option for patients especially those requiring routine or life-long surveillance.