Responsiveness of the modified Medical Research Council dyspnea scale in laryngotracheal stenosis: a retrospective study correlating with the Empey Index

Abstract Background Laryngotracheal stenosis (LTS) is a potentially life-threatening narrowing of the airway that can severely impact respiratory function and quality of life. Accurate assessment of symptom severity is essential for guiding treatment, which often includes endoscopic dilation or surgical intervention. The modified Medical Research Council (mMRC) dyspnea scale is a widely used, patient-reported measure of breathlessness, while the Empey Index offers an objective spirometric assessment of upper airway obstruction. Although the mMRC scale is widely used internationally, its use in Arabic-speaking patients with LTS has not been formally evaluated. This study evaluates the responsiveness of the mMRC scale in patients with LTS undergoing balloon dilation and examines its correlation with the Empey Index. Methods A retrospective case series was conducted at a tertiary academic center in Saudi Arabia. Twenty-six Arabic-speaking adults with LTS underwent endoscopic balloon dilation between 2022 and 2024. Pre- and post-intervention mMRC scores and Empey Index values were compared using paired t-tests. Correlation and univariate regression analyses were performed to explore relationships and predictors of improvement. Results The mean mMRC score significantly improved from 2.44 ± 1.25 to 0.74 ± 1.35 (p < 0.001), and the Empey Index improved from 13.72 ± 2.85 to 11.62 ± 2.95 (p < 0.001). Change in mMRC moderately correlated with change in Empey Index (r = 0.443, p = 0.021). No clinical variables significantly predicted mMRC improvement; however, smoking status predicted Empey Index response. Conclusion The mMRC scale is a responsive, patient-reported tool for monitoring dyspnea in LTS and demonstrates moderate correlation with Empey Index improvement. It offers a simple and accessible metric for monitoring treatment response.