{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:44:40Z","timestamp":1763037880373,"version":"3.40.5"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Repeat endoscopic dilation (ED) in the operating room for subglottic stenosis (SGS) remains an economic burden to patients. The cost\u2010effectiveness (CE) of adjuvant serial intralesional steroid injections (SILSI) to prolong the surgery\u2010free interval (SFI) in SGS patients requiring ED has yet to be studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Details of the cost of SILSI and ED were received from our tertiary academic center. SFI, cost of intervention, and the effect of SILSI on prolonging SFI were collected from a systematic review by Luke et al. SGS etiologies in the review included idiopathic, iatrogenic, or autoimmune. A break\u2010even analysis, comparing the cost of SILSI alone with the cost of repeat ED, was performed to determine if SILSI injections were cost\u2010effective in prolonging the SFI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average extension of the SFI with SILSI was an additional 219.3\u2009days compared to ED alone based on a systematic review of the literature. 41\/55 (74.5%) cases did not require further ED once in\u2010office SILSI management began. SILSI administered in a 4\u2010dose series in 3\u2010to\u20107\u2010week intervals (~$7,564.00) is CE if the reported recurrence rate of SGS requiring ED (~$39,429.00) has an absolute risk reduction (ARR) of at least 19.18% with the use of SILSI. Based on the literature, SILSI prevents ~3 out of every 4 cases of SGS at sufficient follow\u2010up from undergoing repeat ED, resulting in an ARR of ~75%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SILSI is economically reasonable if it prolongs the SFI of at least one case of recurrence out of 5. SILSI, therefore, can be CE in extending the interval for surgical ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 133:3436\u20133442, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30800","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T11:43:29Z","timestamp":1686138209000},"page":"3436-3442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost\u2010Effectiveness of Steroids for Prolonging the <scp>Surgery\u2010Free<\/scp> Interval in Subglottic Stenosis"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0697-8774","authenticated-orcid":false,"given":"Jake A.","family":"Langlie","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke J.","family":"Pasick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-0158","authenticated-orcid":false,"given":"David E.","family":"Rosow","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"MalmivaaraA Sl\u00e4tisP Heli\u00f6vaaraM et al.Surgical or Nonoperative Treatment for Lumbar Spinal Stenosis? 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