# Peak Flow as a Predictor: Identifying When Surgical Intervention Is Required in Recurrent Subglottic Stenosis

## TL;DR

This case report shows how peak expiratory flow (PEF) can help decide when to perform surgery for a recurring airway condition called subglottic stenosis.

## Contribution

The report demonstrates the practical use of PEF monitoring as a remote tool to guide bronchoscopic intervention timing in subglottic stenosis.

## Key findings

- Home PEF meter readings effectively guided the timing of bronchoscopic intervention in a patient with recurrent subglottic stenosis.
- Remote monitoring tools like PEF can help track disease progression and improve clinical decision-making.
- Validating these tools could enhance patient outcomes and streamline clinical workflows.

## Abstract

Subglottic stenosis (SGS) is a narrowing of the airway below the vocal cords, caused by congenital, idiopathic, or acquired factors. Management of SGS is difficult due to high recurrence rates. Objective tools, such as the SGS-6 questionnaire, peak expiratory flow (PEF), and expiratory disproportion index, have shown promise in assessing disease severity and guiding treatment timing. This case presents a 64-year-old man whose SGS was successfully managed using home PEF meter readings to guide timing for bronchoscopic intervention with balloon dilation. Remote tools, such as PEF monitoring, have proven effective in identifying the need for timely intervention. This case report aims to highlight the role of PEF in monitoring SGS progression and predicting the need for the next bronchoscopic intervention. Further validation of these remote tools should be encouraged to enhance patient outcomes, track disease progression, and streamline clinical workflows.