A Comparative Study of Cricotracheal Resection and Staged Laryngotracheoplasty for Adult Subglottic Stenosis

作者：Ching Harry H; Mendelsohn Abie H^*; Liu Isabelle Y; Long Jennifer; Chhetri Dinesh K; Berke Gerald S

来源：Annals of Otology, Rhinology and Laryngology, 2015, 124(4): 326-333.

DOI：10.1177/0003489414554942

• acquired subglottic stenosis
• cricotracheal resection
• laryngotracheoplasty

Objective: Cricotracheal resection (CTR) and laryngotracheoplasty (LIP) are open surgical treatments for severe subglottic stenosis. This study aims to compare the applications, and outcomes of these techniques.
Method: 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.
Result: Sixty-one and 20 patients underwent LIP 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 LIP patients and 90.0% of CTR patients were decannulated. On multivariate analysis, there was a significant association between stenosis grade and decannulation in the LIP 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.
Conclusion: Cricotracheal resection and LIP 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.

• 出版日期2015-4