{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T01:59:58Z","timestamp":1781143198904,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Idiopathic subglottic stenosis (iSGS) is a disease of unclear etiology and predictable phenotype. While surgical dilatation is the mainstay of management, a subset of patients experiences recurrent disease with minimal long\u2010term symptomatic relief. This study evaluates whether systemic immunosuppression alongside surgical management is an effective adjunctive treatment strategy in this patient cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on patients at a tertiary airway center with isolated SGS. The cohort was categorized into idiopathic SGS and granulomatosis with polyangiitis SGS (GPA\u2010SGS). A sub\u2010cohort of iSGS patients with aggressive disease was classified as \u201catypical\u2010SGS.\u201d Both atypical\u2010SGS and GPA\u2010SGS cohorts received systemic immunosuppression alongside surgery and disease activity was assessed before and after immunosuppression through the inter\u2010dilation interval (IDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty patients were included: 33 with iSGS, 20 with GPA\u2010SGS, and 7 with atypical SGS. The iSGS cohort had an indolent disease course, with a median IDI of 17.6\u2009months (IQR 16.0\u201325.0); none received immunosuppression. GPA\u2010SGS patients demonstrated significantly shorter intervals prior to treatment (median 8.9\u2009months, IQR 3.8\u201328.0), improving to 26.0\u2009months (IQR 9.3\u201336.7) following immunosuppression (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0027). Similarly, in atypical SGS, IDI increased from 7.6\u2009months (IQR 6.8\u201312.0) to 27.8\u2009months (IQR 12.0\u201349.0) post\u2010treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0496). No significant adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Atypical SGS represents a diagnostically ambiguous yet clinically aggressive subset of SGS. Systemic immunosuppression, typically reserved for GPA, may prolong disease\u2010free intervals in both GPA\u2010SGS and atypical SGS. These findings support multidisciplinary evaluation and consideration of immunotherapy in frequently recurring, ANCA\u2010negative SGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70466","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:06:00Z","timestamp":1772982360000},"page":"3103-3110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Immunosuppression to Reduce Surgical Intervention in\n                    <scp>ANCA<\/scp>\n                    \u2010Negative Subglottic Stenosis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-4296","authenticated-orcid":false,"given":"Guy","family":"Benshetrit","sequence":"first","affiliation":[{"name":"National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust  London UK"},{"name":"Vasculitis Centre, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McAdoo","sequence":"additional","affiliation":[{"name":"Vasculitis Centre, Imperial College London  London UK"},{"name":"Vasculitis Clinic, Hammersmith Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romana","family":"Kuchai","sequence":"additional","affiliation":[{"name":"National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust  London UK"},{"name":"Vasculitis Centre, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Pusey","sequence":"additional","affiliation":[{"name":"Vasculitis Centre, Imperial College London  London UK"},{"name":"Vasculitis Clinic, Hammersmith Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guri","family":"Sandhu","sequence":"additional","affiliation":[{"name":"National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust  London UK"},{"name":"Vasculitis Centre, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadwan","family":"Al\u2010Yaghchi","sequence":"additional","affiliation":[{"name":"National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust  London UK"},{"name":"Vasculitis Centre, Imperial College London  London UK"},{"name":"Department of Surgery and Cancer, 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