Comorbidities and factors associated with endoscopic surgical outcomes in adult laryngotracheal stenosis.
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.
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.
Pelin
P
Kocdor
Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, USA.
Eric R
ER
Siegel
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.
James Y
JY
Suen
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.
Gresham
G
Richter
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. oetulunayugur@uams.edu.
Ozlem E
OE
Tulunay-Ugur
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004106:Dilatation / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007829:Laryngostenosis / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014135:Tracheal Stenosis / Q000453:epidemiology* / Q000601:surgery; D014140:Tracheotomy / Q000379:methods*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
Adult subglottic stenosis; Comorbidity; Endoscopic dilatation; Laryngotracheal stenosis; Outcomes