Comorbidities and factors associated with endoscopic surgical outcomes in adult laryngotracheal stenosis

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• 作者：Pelin Kocdor ; Eric R. Siegel ; James Y. Suen…
• 关键词：Outcomes ; Adult subglottic stenosis ; Laryngotracheal stenosis ; Endoscopic dilatation ; Comorbidity
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：273
• 期：2
• 页码：419-424
• 全文大小：425 KB
• 参考文献：1.Nouraei SA, Ma E, Patel A, Howard DJ, Sandhu GS (2007) Estimating the population incidence of adult postintubation laryngotracheal stenosis. Clin Otolaryngol 32:411–412PubMed CrossRef
  2.Poetker DM, Ettema SL, Blumin JH, Toohill RJ, Merati AL (2006) Association of airway abnormalities and risk factors in 37 subglottic stenosis patients. Otolaryngol Head Neck Surg 135:434–437PubMed CrossRef
  3.Myer CM III, O’Connor DM, Cotton RT (1994) Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 103:319–323PubMed CrossRef
  4.Parker NP, Bandyopadhyay D, Misono S, Goding GS (2013) Endoscopic cold incision, balloon dilation, mitomycin c application, and steroid injection for adult laryngotracheal stenosis. Laryngoscope 123:220–225PubMed CrossRef
  5.Weymuller EA (1988) Laryngeal injury from prolonged endotracheal intubation. Laryngoscope 98:1–15PubMed CrossRef
  6.Tong CC, Kleinberger AJ, Paolino J, Altman KW (2012) Tracheotomy timing and outcomes in the critically ill. Otolaryngol Head Neck Surg 147(1):44–51PubMed CrossRef
  7.Valdez TA, Shapshay SM (2002) Idiopathic subglottic stenosis revisited. Ann Otol Rhinol Laryngol 111:690–695PubMed CrossRef
  8.Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101:1–78PubMed CrossRef
  9.Blumin JH, Johnston N (2011) Evidence of extraesophageal reflux in idiopathic subglottic stenosis. Laryngoscope 121:1266–1273PubMed CrossRef
  10.Richter JE (2003) Gastroesophageal reflux disease during pregnancy. Gastroenterol Clin North Am 32:235–261PubMed CrossRef
  11.Zhang Q, Horowitz M, Rigda R et al (2004) Effect of hyperglycemia on triggering of transient lower esophageal sphincter relaxations. Am J Physiol Gatrointest Liver Physiol 286:G797–G803CrossRef
  12.Lee KH, Rutter MJ (2008) Role of balloon dilation in the management of adult idiopathic subglottic stenosis. Ann Otol Rhinol Laryngol 117:81–84PubMed
  13.Simpson GT, Strong MS, Healhy GB et al (1982) Predictive factors of success or failure in the endoscopic management of laryngeal and tracheal stenosis. Ann Otol Rhinol Laryngol 91:384–388PubMed CrossRef
  14.Yamamoto K, Kojima F, Tomiyama K, Nakamura T, Hayashino Y (2011) Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults. Ann Thorac Surg 91:1747–1753PubMed CrossRef
  15.Halmos GB, Van der Laan BF, Dikkers FG (2009) Groningen dilatation tracheoscope in the treatment of moderate subglottic and tracheal stenosis. Ann Otol Rhinol Laryngol 118:329–335PubMed CrossRef
  16.McCaffrey TV (1993) Management of laryngotracheal stenosis on the basis of site and severity. Otolaryngol Head Neck Surg 109:468–473PubMed CrossRef
  17.Ettema SL, Loerhl TA, Toohill R et al (2007) The prevalence of diabetes in a series of patients with subglottic stenosis. Ear Nose Throat J 86:687–690PubMed
  18.Pearce EN (2012) Thyroid hormone and obesity. Curr Opin Endocrinol Diabetes Obes 19:408–413PubMed CrossRef
  19.Attal P, Chanson P (2010) Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab 95:483–495PubMed CrossRef
  
• 作者单位：Pelin Kocdor (1)
  Eric R. Siegel (2)
  James Y. Suen (1)
  Gresham Richter (1)
  Ozlem E. Tulunay-Ugur (1)
  
  1. Division of Laryngology, Department of Otolaryngology Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 W Markham, Slot 543, Little Rock, AR, 72205, USA
  2. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726

文摘

This study which is a retrospective chart review aims to characterize the comorbidities associated with adult laryngotracheal stenosis and evaluate the relationship of these with stenosis grade, length, surgical interventions, and surgical intervals. Patients’ demographics, medical and surgical comorbidities, grade of stenosis, quantity and degree of balloon dilations, dilation intervals, open airway procedures, and tracheotomy status were recorded from 2002 to 2012, at a tertiary voice and airway center. Surgical outcomes were evaluated in relation to patient comorbidities, stenosis quality, and surgical procedures. A total of 101 patients with laryngotracheal stenosis were examined with female patients comprising 71 % of the population. Seventeen patients (16.8 %) had idiopathic stenosis. Number of balloon dilations ranged from 0 to 24 (mean = 3.3). The average time between dilations was 38.4 weeks (range = 1.14–215.8 weeks). The patients with idiopathic stenosis were found to have a lower grade (p = 0.0066). Fifty-two patients (51.5 %) received a tracheotomy at one point during their management. The 14 patients (13.9 %) who remained tracheotomy dependent had a body mass index (BMI) of >30. No statistically significant correlation was found when the patients’ age, BMI and comorbidites were compared with the grade of stenosis, number of balloon dilatations needed and other surgical interventions. On the other hand, interval in between surgeries was found to be longer in patients without an intubation history, and in idiopathic SGS (p = 0.004, p = 0.015, respectively). There was no significant relationship between surgical interval and gender, BMI, length of stenosis, grade (p = 0.059, p = 0.47, p = 0.97, p = 0.36, respectively). Airway stenosis in adults is complicated by the presence of multiple comorbidities. Better understanding of the etiology could aid in the prevention of the injury before it forms. Keywords Outcomes Adult subglottic stenosis Laryngotracheal stenosis Endoscopic dilatation Comorbidity