title: A comparative study of cricotracheal resection and staged laryngotracheoplasty for adult subglottic stenosis.
abstract: OBJECTIVE
  Cricotracheal resection (CTR) and laryngotracheoplasty (LTP) are open surgical treatments for severe subglottic stenosis. This study aims to compare the applications and outcomes of these techniques.
  
  
  METHODS
  Patients with subglottic stenosis at a tertiary academic institution from 2000 to 2012 were identified by diagnosis codes. Patients who underwent LTP or CTR were included. Records were reviewed for treatment data and outcomes. Patients with a history of head and neck malignancy or stenosis without cricoid involvement were excluded.
  
  
  RESULTS
  Sixty-one and 20 patients underwent LTP and CTR, respectively. When comparing patients receiving LTP and CTR, there was a significant difference in stenosis etiology (P=.014). The groups were similar in Cotton-Myer grade (P=.102). At last follow-up, 80.3% of LTP patients and 90.0% of CTR patients were decannulated. On multivariate analysis, there was a significant association between stenosis grade and decannulation in the LTP group (P=.01). Decannulation was not associated with stenosis grade in the CTR group. In both groups, there was no significant association between decannulation and sex, stenosis etiology, or stenosis length.
  
  
  CONCLUSIONS
  Cricotracheal resection and LTP have both shown excellent long-term decannulation rates. Etiology and stenosis grade are likely to be determining factors when recommending specific surgical interventions for subglottic stenosis.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Harry H
authors.initials: HH
authors.lastname: Ching
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA amendelsohn@mednet.ucla.edu.
authors.forename: Abie H
authors.initials: AH
authors.lastname: Mendelsohn
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Isabelle Y
authors.initials: IY
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Chhetri
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Berke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: acquired subglottic stenosis; cricotracheal resection; laryngotracheoplasty