Utility of Two-Stage Laryngotracheal Reconstruction in the Management of Subglottic Stenosis in Adults

Deckard, Nathan A.; Yeh, Justin; Soares, Danny J.; Criddle, Michael; Stachler, Robert J.; Coticchia, James M.

doi:10.1177/000348941312200506

Cited by 7 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nakache et al (5) achieved the primary goal in 68% of cases as the decannulation rate increased to 88.5% after different types of revision surgery. Similar results are seen in the data published by Rubikas et al (6), 86.3%, and Deckard et al (7), 86%. Additionally, the group of Rubikas reported perioperative complications of 34.8% within 30 days of the operation in the group with cricotracheal resection.…”

Section: Discussionsupporting

confidence: 91%

Cricotracheal Resection in a Patient with Severe Subglottic Stenosis - Advantages of a Temporary Non-Cannulated Tracheostomy

Popov¹,

Marinov²,

Rangachev³

et al. 2017

Balkan Med J

View full text Add to dashboard Cite

Background:Stenosis in the area of the cricotracheal segment is still a challenging problem to be dealt with. Post-intubational cases mark an increase in recent years due to the advances in intensive care, thoracic surgery and neurosurgery departments.Case Report:This paper describes a case report of a patient with severe subglottic stenosis (grade III according to the Cotton-Myer scale), introduces a new option in cricotracheal resections - postoperative temporary non-cannulated tracheostomy and describes its advantages.Conclusion:This variation of classical operative techniques provides additional fixation of the trachea, thus relieving any transitory tension on the anastomosis; acts as a valve and decreases the air-pressure in the upper airways during coughing and sneezing in the post-operative period; and is an easy access point for video tracheoscopy of the anastomosis.

show abstract

Section: Discussionsupporting

confidence: 91%

Cricotracheal Resection in a Patient with Severe Subglottic Stenosis - Advantages of a Temporary Non-Cannulated Tracheostomy

Popov¹,

Marinov²,

Rangachev³

et al. 2017

Balkan Med J

View full text Add to dashboard Cite

show abstract

“…According to guiding principles beyond the scope of this study, the type of airway reconstruction was matched with the pathologic characteristics of the patient's disease to maximize airway improvement while minimizing surgical morbidity. [23][24][25][26][27] Surgical operations for LTS were classified as tracheal resection, cricotracheal resection, extended resection (with concomitant posterior costal cartilage graft), tracheoplasty (using auricular cartilage to repair tracheocutaneous fistula), or laryngotracheal reconstruction (LTR). Laryngotracheal reconstructions were further categorized as an isolated posterior costal cartilage graft, endoscopic posterior costal cartilage graft, isolated anterior costal cartilage graft, or both anterior and posterior graft LTR.…”

Section: Methodsmentioning

confidence: 99%

“…According to guiding principles beyond the scope of this study, the type of airway reconstruction was matched with the pathologic characteristics of the patient’s disease to maximize airway improvement while minimizing surgical morbidity . Surgical operations for LTS were classified as tracheal resection, cricotracheal resection, extended resection (with concomitant posterior costal cartilage graft), tracheoplasty (using auricular cartilage to repair tracheocutaneous fistula), or laryngotracheal reconstruction (LTR).…”

Section: Methodsmentioning

confidence: 99%

Association Between Red Blood Cell Distribution Width and Outcomes of Open Airway Reconstruction Surgery in Adults

Xie

Rehman

Francis

et al. 2019

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

aryngotracheal stenosis (LTS) is a life-threatening, fixed, extrathoracic restriction in pulmonary ventilation. It is an umbrella term that encompasses airway compromise at the level of the larynx, subglottis, or cervical trachea and is a common consequence of multiple pathophysiologic processes. 1-3 The goal of surgical treatment is to improve airway caliber to mitigate the patient's dyspnea and achieve prosthesisfree breathing (eg, without tracheostomy, intraluminal stent, or T-tube). 2,4-10 Successful surgical outcomes depend on many factors, including technical expertise, pulmonary function, and patient characteristics. Rates of achieving prosthesis-free breathing after adult open airway reconstruction surgery vary in the literature from 57% to 100%. 10 With few exceptions, 3 all LTS surgical studies have been small, single-institution case series. To date, variables associated with prosthesis-free breathing after LTS surgery include anatomical (eg, degree of luminal compromise, length of stenosis, and laryngeal involvement) 3,5 and patient-specific (eg, diabetes, obstructive sleep apnea, congestive heart failure, and gastroesophageal reflux disease) factors. 4,8 Despite the importance of preoperative risk stratification to minimize postoperative IMPORTANCE Airway reconstruction for adults with laryngotracheal stenosis (LTS) is directed toward improving airway caliber to mitigate the patient's dyspnea and achieve prosthesis-free breathing (ie, without tracheostomy, intraluminal stent, or T-tube). Despite the importance of preoperative risk stratification to minimize postoperative complications, consensus on an objective predictive algorithm for open airway reconstruction is lacking. OBJECTIVE To determine whether the ability to achieve a prosthesis-free airway in adults after open airway reconstruction is associated with red blood cell distribution width (RDW) at the time of surgery. DESIGN, SETTING, AND PARTICIPANTS Case series study investigating 92 consecutive patients 18 years and older with laryngotracheal stenosis who underwent open airway reconstruction at a US tertiary care hospital from January 1, 2006, to January 1, 2017. MAIN OUTCOMES AND MEASURES The main outcome was a prosthesis-free airway (absence of tracheostomy, intraluminal stent, or T-tubes) at last follow-up. Multivariate logistic regression modeling was used to identify independent factors associated with this outcome. RESULTS Of the 92 patients who met inclusion criteria, the median (interquartile range) age was 44 (33.0-60.3) years; 50 (53%) were female, and 82 (89%) were white. In all, 74 patients (80%) were prosthesis free at the last follow-up (mean, 833 days; 95% CI, 10-4229 days). In multivariate analyses, airway decannulation was significantly correlated with reduced RDW (odds ratio [OR], 0.40; 95% CI, 0.19-0.84) and the absence of posterior glottic stenosis (OR, 0.12; 95% CI, 0.04-0.37). CONCLUSIONS AND RELEVANCE These data suggest that surgical success in open airway reconstruction is significantly associated with RDW and whethe...

show abstract

Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis

et al. 2016

View full text Add to dashboard Cite

show abstract

Utility of Two-Stage Laryngotracheal Reconstruction in the Management of Subglottic Stenosis in Adults

Cited by 7 publications

References 33 publications

Cricotracheal Resection in a Patient with Severe Subglottic Stenosis - Advantages of a Temporary Non-Cannulated Tracheostomy

Cricotracheal Resection in a Patient with Severe Subglottic Stenosis - Advantages of a Temporary Non-Cannulated Tracheostomy

Association Between Red Blood Cell Distribution Width and Outcomes of Open Airway Reconstruction Surgery in Adults

Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis

Contact Info

Product

Resources

About