{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:40:42Z","timestamp":1787773242205,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Managing idiopathic subglottic stenosis (iSGS) during pregnancy presents distinct clinical challenges. As pregnancy is a naturally dyspneic state, the development of iSGS may exacerbate respiratory symptoms and compromise the airway\u2014potentially impacting pregnancy and delivery decisions. This study characterizes surgical management strategies and outcomes in pregnant patients with symptomatic iSGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted the largest known multi\u2010institutional retrospective review of pregnant patients who underwent endoscopic intervention for iSGS. Demographics, procedural details, anesthesia and medication use, and maternal and neonatal outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve patients underwent 15 endoscopic procedures during pregnancy: 9 laser wedge excisions (8 CO\n                      <jats:sub>2<\/jats:sub>\n                      laser and 1 coblator) and 6 balloon dilations. Three additional procedures in different patients occurred postpartum (2\u201311\u2009months after delivery). Higher\u2010risk pregnancies included two twin gestations, one patient with multiple surgeries during two different pregnancies, and two patients over age 35. Most interventions (87%) occurred in the second trimester. Fetal monitoring was performed preoperatively and postoperatively. Fentanyl and propofol were used in 88% and 94% of cases, respectively; rocuronium was the most common neuromuscular blocker (70%). One patient underwent balloon dilation via flexible bronchoscopy without anesthesia. Jet ventilation was used in 53% of cases, and Size C Kleinsasser laryngoscopes in 47%. Median procedure times were 75, 19, and 18\u2009min for laser wedge excision, balloon dilation, and coblation, respectively. Most patients delivered full\u2010term with no surgical or postpartum complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic intervention for iSGS during pregnancy appears safe and effective, even in high\u2010risk cases. These findings support individualized airway management and inform future practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32464","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T09:30:24Z","timestamp":1753781424000},"page":"4767-4773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Management of Idiopathic Subglottic Stenosis During Pregnancy: A Multi\u2010Institutional Study"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-7388","authenticated-orcid":false,"given":"Andrew S.","family":"Awadallah","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2148-6486","authenticated-orcid":false,"given":"Yousuf H.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-7932","authenticated-orcid":false,"given":"Andrew J.","family":"Bowen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery MetroHealth Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6197-8593","authenticated-orcid":false,"given":"Hawa M.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3955-450X","authenticated-orcid":false,"given":"Sydney","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monet","family":"McCalla","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-5892","authenticated-orcid":false,"given":"David O.","family":"Francis","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3299-3014","authenticated-orcid":false,"given":"Seth H.","family":"Dailey","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Edell","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Koster","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semirra L.","family":"Bayan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8770-8463","authenticated-orcid":false,"given":"Dale C.","family":"Ekbom","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mayo Clinic  Rochester Minnesota 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