Idiopathic Subglottic Stenosis: Surgical and Therapeutic Results in an Adult Woman

Introduction: Subglottic stenosis is a condition leading to narrowing of subglottal space due to intubation, inflammation, tracheostomy, trauma, and idiopathic conditions. Respiratory effort of the patient increases due to this narrowing. The effect is also perceived in speech production as effortful exhalation, unnatural pause due to shallow breathing, and muscle tension. Surgical treatment including cricoplasty and tracheal anastomosis can improve respiratory function but adversely affect voice production, especially in adult women. The following case study is a retrospective voice analysis of an adult female before and after cricoplasty and voice therapy. Methodology: Forty seven year female, diagnosed with Idiopathic subglottic stenosis, was seen pre and post-tailored cricoplasty. The patient underwent eighteen sessions of voice therapy. Pre-post-operative and post-therapy measures of Voice Handicap Index-10, Consensus Auditory Perceptual Evaluation – Voice, fundamental frequency, speaking fundamental frequency, perturbation measures like jitter, and shimmer were compared after therapy. Results: All the above mentioned voice measures were affected negatively after surgery; however, the patient showed substantial improvement after therapy. Transgender therapy approach helped considerably in this improvement. Conclusions: This is a single case study. The authors suggest that considering voice therapy before and after surgery may improve prognosis of patients' voice and satisfaction of treatment.