Challenges in the Management of Laryngeal Stenosis

Nair, Satish; Nilakantan, Ajith; Sood, Amit; Gupta, Atul; Gupta, Abhishek

doi:10.1007/s12070-015-0936-2

Cited by 25 publications

(28 citation statements)

References 11 publications

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“…Laryngotracheal stenosis (LTS) is a chronic and potentially life‐threatening condition with a range of presentations from mild dyspnea to long‐term tracheostomy dependence . LTS is characterized anatomically based on the level of narrowing in the airway; the subglottis is the most common site of involvement . It is a complex and difficult condition with significant rates of recurrence despite proper treatment.…”

Section: Introductionmentioning

confidence: 99%

The minimal clinically important difference of the dyspnea index in laryngotracheal stenosis

et al. 2019

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Objective The Dyspnea Index (DI) is a validated patient‐reported outcome (PRO) instrument that has been used in the management of laryngotracheal stenosis (LTS). The minimal clinically important difference (MCID) is an established concept to help determine the change in a PRO instrument that reflects meaningful change for the patient. It is not known what change in the DI is of clinical significance in airway surgery. This study aims to determine the MCID for the DI in patients undergoing surgical treatment for LTS. Methods This is a prospective cohort study in which 26 patients with LTS completed the DI (score range 0 to 40) before and 6 to 8 weeks postoperatively, in addition to a Global Ratings Change Questionnaire (GRCQ), scored from −7 to +7, at the postoperative interval. A hypothesis test was carried out to test the association between GRCQ and change in DI. The MCID for change in DI was determined using anchor‐based analysis. Results Overall mean change in DI was −11, and mean change in GRCQ was +5. Change in DI scores were significantly different among the improvement and no improvement groups (P value <0.002). Area under the receiver operating curve was 0.92, demonstrating high discriminatory ability of the change in DI score. A change of −4 was determined to be the threshold that discriminated between significant improvement and no improvement. Conclusion A decrease of 4 in the DI can be considered as the MCID for patients with LTS after surgical treatment. Level of Evidence 2b Laryngoscope, 130:1775–1779, 2020

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Section: Introductionmentioning

confidence: 99%

The minimal clinically important difference of the dyspnea index in laryngotracheal stenosis

et al. 2019

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“…Endoscopy is the gold standard for evaluating the severity of the stenosis. Surgical therapy is dependent on the site, severity and the symptoms of the stenosis (1).…”

Section: Introductionmentioning

confidence: 99%

“…LS can also be produced by acid reflux and the presence of the intubation and naso-gastric tube. Due to an important number of women are affected by LS sex hormones have been evaluated, but no estrogen receptors were remarked (1). Pathology modifications which appear due to external factors are submucosal oedema followed by fibroblastic proliferation and tissue formation.…”

Section: Introductionmentioning

confidence: 99%

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Larynx stenosis; a challenge for the ENT surgeons

Berteșteanu¹,

Pascu²,

Popescu³

et al. 2018

J Clin Invest Surg.

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Laryngo-tracheal stenosis is a complex pathology which requires multiple surgical interventions and diligence from the surgeon and patience from the patient so that normal physiology may be restored. The aim of this paper is to evaluate the factors that can influence the evolution of this pathology. It is presented a retrospective study in which 20 cases of larynx stenosis from 2008 until 2018 were evaluated. The study revealed a predominance of the pathology in men, especially from rural environment. The etiology of larynx stenosis was both iatrogenic and traumatic. Multiple surgical interventions classical and endoscopic were necessary, along with tracheostomy. In 7 cases there was the need for larynx stent to be mounted. There was no significant correlation between age, etiology and the site of stenosis and the removal of the tracheostomy. Larynx stenosis benefit in present by modern surgical techniques. Current therapeutic options include conservative therapy, endoscopic approach and external approach depending on the site, severity, morbidities of the stenosis. Even if technology is of great help in LS management of many patients, unfortunately there are still cases where therapy is very complex and with poor functional results.

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“…В ряде наблюдений после эндопротезирова-ния при резекциях гортани не удавалось восстановить просвет органа из-за роста грануляций, наличия руб-цовых стенозов различных размеров и протяженности, ларинготрахеомаляции (7-30 %) [1]. Для лечения этих осложнений проводят эндоскопические операции с применением лазера, микрохирургических инстру-ментов и повторные открытые операции с оформлением ларингостомы и формированием просвета на Т-образной трубке [18]. Таким образом, вопрос выбора вида и ме-тода хирургического лечения больных раком гортани остается открытым.…”

Section: Introductionunclassified