@article{Dronkers:2026:10.1002/lary.70032,
author = {Dronkers, EAC and Clunie, GM and Iacovidou, A and Nouraei, SAR and Al, Yaghchi C and Sandhu, GS},
doi = {10.1002/lary.70032},
journal = {The Laryngoscope},
pages = {243--250},
title = {Management of subglottic stenosis with the “Maddern procedure”: long term followup outcomes},
url = {http://dx.doi.org/10.1002/lary.70032},
volume = {136},
year = {2026}
}

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TY  - JOUR
AB  - ObjectiveFull-thickness resection and skin grafting of the laryngotracheal junction, the “Maddern Procedure,” can be used to treat patients with recalcitrant laryngotracheal stenosis. We report the long-term surgical outcomes of this procedure.MethodsA consecutive series of 27 females with idiopathic, iatrogenic, or vasculitic subglottic stenosis who underwent the Maddern procedure between 2012 and 2023 were retrospectively reviewed. Airway outcome was assessed using the Modified Medical Research Council Dyspnea (mMRC) Scale. Secondary outcomes included voice, swallowing, mucus management, complications, and the need for subsequent airway surgery.ResultsMost patients had idiopathic subglottic stenosis (n = 20, 74.1%), followed by vasculitic (n = 4, 14.8%) and intubation-related (n = 3, 11.1%) etiologies. Patients had an average of 7.3 (SD 3.4) endoscopic procedures before undergoing the Maddern procedure. Mean pre-Maddern inter-treatment interval was 7.5 months (SD 3.4). The median follow-up was 6.6 years (interquartile range 0.75–11.3). The mMRC dyspnea scale improved from 2.7 (SD 0.73) to 0.52 (SD 0.85). The five-year recurrence-free rate was 63%. It differed between etiologies, ranging from 83% for idiopathic stenosis to 67% for intubation-related and 0% for vasculitis-related stenoses. During the first 4 years after Maddern, 67% of patients reported daily cough and the need to use nebulizers regularly.ConclusionThe Maddern procedure is an effective and durable option for patients with idiopathic subglottic stenosis. Careful screening of patients with presumed idiopathic subglottic stenosis for possible underlying auto-immune conditions remains important when considering patients for this procedure.Level of EvidenceLevel 4.
AU  - Dronkers,EAC
AU  - Clunie,GM
AU  - Iacovidou,A
AU  - Nouraei,SAR
AU  - Al,Yaghchi C
AU  - Sandhu,GS
DO  - 10.1002/lary.70032
EP  - 250
PY  - 2026///
SN  - 0023-852X
SP  - 243
TI  - Management of subglottic stenosis with the “Maddern procedure”: long term followup outcomes
T2  - The Laryngoscope
UR  - http://dx.doi.org/10.1002/lary.70032
UR  - https://doi.org/10.1002/lary.70032
VL  - 136
ER  - 

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