A Modified Laryngeal Stent for Glotto-Subglottic Stenosis: A Novel Stent for Better Outcomes

Wilcox, Jeffrey D.; Nassar, Michel

doi:10.1177/0145561319883074

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…Initial review of the PubMed, Embase, Web of Science, and Cochrane Library, identified a total of 9027 articles, including 2540 from PubMed, 3590 from Embase, 2897 from Web of Science, and 0 from Cochrane Libraries. Twenty‐four studies met the inclusion criteria and 126 patients were included in the study 1,2,6,7,12‐30 . A full list of these studies and their characteristics are recorded in Supplemental Tables S1, available online.…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta‐Analysis

Moore

Walker

Kanotra

2023

Otolaryngol.--head neck surg.

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Objectives. To examine and compare the outcomes of various surgical interventions for congenital laryngeal webs in terms of avoidance of tracheostomy, rate of decannulation, web recurrence, revision surgery, and mortality in children.Data Sources. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted on December 10, 2021, using a comprehensive search in PubMed, Web of Science, Cochrane library, and Embase with no date restriction.Review Methods. Articles on surgical intervention for congenital laryngeal webs in pediatric (<18 years) patients were included in the analysis. Articles including acquired laryngeal webs, no surgical intervention, or exclusively adult population were excluded.Results. 9027 articles were reviewed, 24 articles met the inclusion criteria and 126 patients were included. In patients with Grades I and II webs, there was no significant difference in rates of tracheostomy or decannulation, between endoscopic (100%) versus open approach (100%). For Grades III and IV webs, 96% of patients who received open surgery were decannulated or avoided tracheostomy compared to 84% of those managed endoscopically (p = 0.081). There were significantly lower rates of revision surgery in the open group compared to the endoscopic group (77.8% vs 30.9%, p = 0.008). Conclusion.This study showed no difference in rates of tracheostomy, decannulation, web recurrence, revision, or mortality between endoscopic and open approaches for the treatment of Grades I and II webs. For Grades III and IV, open surgical techniques achieved a lower revision rate. Results should be interpreted in light of associated increased morbidity with open procedures.

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Section: Resultsmentioning

confidence: 99%

“…Twenty-four studies met the inclusion criteria and 126 patients were included in the study. 1,2,6,7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] A full list of these studies and their characteristics are recorded in Supplemental Tables S1, available online. An overview of our method is described in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta‐Analysis

Moore

Walker

Kanotra

2023

Otolaryngol.--head neck surg.

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“…For patients who are unfit for surgery, alternative approaches include tracheotomy and stent implantation ( 3 , 5 , 7 ). As a minimally invasive therapeutic approach, the implantation of laryngotracheal stents, including Montgomery T-tubes and silicone and metallic stents, have been used in the treatment of laryngotracheal stenosis ( 6 , 12 , 13 ). This approach could also provide an alternative solution for patients who are unfit or unwilling to undergo tracheotomy.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experience With a Novel Metallic Segmented Transcordal Stent Modified With Three-Dimensional Printing for Inoperable Malignant Laryngotracheal Stenosis

et al. 2021

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BackgroundThis study aims to assess the feasibility of a novel metallic segmented transcordal stent modified with three-dimensional (3D) printing for treating inoperable malignant laryngotracheal stenosis and the tolerability of the stent.MethodsThis was a retrospective study. The stents were individually customized with the aid of 3D printing model based on the anatomic features of each patient’s airway. The stent was composed of two separate segments that corresponded to the larynx and the upper trachea. The stents were barrel-shaped at the proximal end to prevent migration. The proximal end of the stent was located slightly above the vocal cord. The technical and clinical success of stenting procedure, patient tolerability, and stent-related complications of patients were evaluated.ResultsTen patients with dyspnea caused by malignant laryngotracheal stenosis underwent implantation of such stents. Technical and clinical success of the stenting procedure were achieved in all patients. For all patients, basic communication in life could be maintained by speaking softly. During follow-up, one patient showed intolerance to the stent, and the stent was retrieved 2 weeks after stenting. Stent migration was found in one patient, and the position of the stent was readjusted. Granulation tissue proliferation was found in two patients and was treated with cryotherapy by bronchoscopy. There were no deaths associated with stenting.ConclusionsThe individually customized metallic segmented transcordal stent is feasible and tolerable for patients with inoperable malignant laryngotracheal stenosis. The implantation of this stent may serve as a novel alternative treatment for patients who are not suitable for surgery or tracheotomy.

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“…Tracheal stenting may be considered in a select group of patients with nonmalignant tracheal/subglottic stenoses; however, given the proximity to the larynx, these may require consideration of alternative airway access and a multidisciplinary approach. 38,39 AOFs often pose a challenging management dilemma that requires consideration of all associated clinical risks and benefits in an individualised fashion, including patients' prognosis from the underlying disease. Avoiding catastrophic outcomes as a result of aspiration and allowing patients to have oral intake is often the considered goal.…”

Section: Benefitsmentioning

confidence: 99%

Tracheobronchial stents: an expanding prospect

Lilburn,

Williamson,

Phillips

et al. 2023

Internal Medicine Journal

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The first dedicated tracheobronchial silicone stent was designed by the French pulmonologist Jean‐Paul Dumon. The most common indications for stenting are to minimise extrinsic airway compression from mass effect, maintain airway patency due to intrinsic obstruction or treat significant nonmalignant airway narrowing or fistulae. Silicone stents require rigid bronchoscopy for insertion; however, they are more readily repositioned and removed compared with metallic stents. Metallic stents demonstrate luminal narrowing when loads are applied to their ends, therefore stents should either be reinforced at the ends or exceed the area of stenosis by a minimum of 5 mm. Nitinol, a nickel‐titanium metal alloy, is currently the preferred material used for airway stents. Airway stenting provides effective palliation for patients with severe symptomatic obstruction. Drug‐eluting and three‐dimensional printing of airway stents present promising solutions to the challenges of the physical and anatomical constraints of the tracheobronchial tree. Biodegradable stents could also be a solution for the treatment of nonmalignant airway obstruction.

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A Modified Laryngeal Stent for Glotto-Subglottic Stenosis: A Novel Stent for Better Outcomes

Cited by 4 publications

References 12 publications

Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta‐Analysis

Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta‐Analysis

Preliminary Experience With a Novel Metallic Segmented Transcordal Stent Modified With Three-Dimensional Printing for Inoperable Malignant Laryngotracheal Stenosis

Tracheobronchial stents: an expanding prospect

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