PMID- 28195821
OWN - NLM
STAT- MEDLINE
DCOM- 20170816
LR  - 20220408
IS  - 1097-6817 (Electronic)
IS  - 0194-5998 (Linking)
VI  - 156
IP  - 5
DP  - 2017 May
TI  - Idiopathic Subglottic Stenosis: Long-Term Outcomes of Open Surgical Techniques.
PG  - 906-911
LID - 10.1177/0194599817691955 [doi]
AB  - Objectives Idiopathic subglottic stenosis (iSGS) is rare, and its cause remains 
      elusive. Treatment options include empiric medical therapy and endoscopic or open 
      surgery. We present our results for open surgical technique. Study Design Case 
      series with chart review (1978-2015). Setting Tertiary academic center. 
      Subjects/Methods Thirty-three patients (32 female; median age, 51 years) met 
      inclusion criteria and underwent cricotracheal resection with thyrotracheal 
      anastomosis, tracheal resection with primary anastomosis, or laryngotracheoplasty 
      with rib grafting. Continuous variables were summarized using medians and ranges 
      while categorical features are presented using frequency counts and percentages. 
      Results Sixteen patients (48%) underwent a single-stage approach with immediate 
      extubation or temporary intubation following surgery (median, 1 day; range, 1-3 
      days). Seventeen patients (52%) underwent a double-staged approach with a median 
      time to decannulation of 35 days (range, 13-100 days). Twenty-four (73%) patients 
      underwent a previous intervention. Median stay in the intensive care unit was 1 
      day (range, 0-3 days), with a median hospital stay of 4 days (range, 2-7 days). 
      Recurrence requiring further surgical intervention was observed in 12 patients 
      (36%). The median time to recurrence was 8 years over an average follow-up of 9.7 
      years. The most common complaint following surgery was change in voice quality 
      (fair to poor; n = 10; 30%). Conclusions Open surgery should be reserved for 
      refractory cases of iSGS; cricotracheal resection with thyrotracheal anastomosis 
      is the preferred open technique. Recurrence may occur after open treatment, 
      highlighting the importance of long-term follow-up. Patients should be counseled 
      about the potential for worsening voice quality with the open approach.
FAU - Menapace, Deanna C
AU  - Menapace DC
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Minnesota, 
      Rochester, Minnesota, USA.
FAU - Modest, Mara C
AU  - Modest MC
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Minnesota, 
      Rochester, Minnesota, USA.
FAU - Ekbom, Dale C
AU  - Ekbom DC
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Minnesota, 
      Rochester, Minnesota, USA.
FAU - Moore, Eric J
AU  - Moore EJ
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Minnesota, 
      Rochester, Minnesota, USA.
FAU - Edell, Eric S
AU  - Edell ES
AD  - 2 Department of Pulmonology, Mayo Clinic School of Medicine, Rochester, 
      Minnesota, USA.
FAU - Kasperbauer, Jan L
AU  - Kasperbauer JL
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Minnesota, 
      Rochester, Minnesota, USA.
LA  - eng
PT  - Journal Article
DEP - 20170214
PL  - England
TA  - Otolaryngol Head Neck Surg
JT  - Otolaryngology--head and neck surgery : official journal of American Academy of 
      Otolaryngology-Head and Neck Surgery
JID - 8508176
SB  - IM
CIN - Otolaryngol Head Neck Surg. 2017 May;156(5):781-782. PMID: 28457219
MH  - Academic Medical Centers
MH  - Adult
MH  - Aged
MH  - Anastomosis, Surgical/methods
MH  - Bone Transplantation/*methods
MH  - Cohort Studies
MH  - Cricoid Cartilage/*surgery
MH  - Dyspnea/diagnosis/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Laryngoplasty/*methods
MH  - Laryngoscopy/methods
MH  - Laryngostenosis/complications/diagnosis/*surgery
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures/adverse effects/methods
MH  - Patient Selection
MH  - Postoperative Complications/physiopathology/surgery
MH  - Recurrence
MH  - Reoperation/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Tertiary Care Centers
MH  - Tracheal Stenosis/complications/diagnosis/*surgery
MH  - Treatment Outcome
MH  - Voice Quality
OTO - NOTNLM
OT  - cricotracheal resection
OT  - idiopathic subglottic stenosis
OT  - laryngotracheoplasty
OT  - tracheal resection
EDAT- 2017/02/15 06:00
MHDA- 2017/08/17 06:00
CRDT- 2017/02/15 06:00
PHST- 2017/02/15 06:00 [pubmed]
PHST- 2017/08/17 06:00 [medline]
PHST- 2017/02/15 06:00 [entrez]
AID - 10.1177/0194599817691955 [doi]
PST - ppublish
SO  - Otolaryngol Head Neck Surg. 2017 May;156(5):906-911. doi: 
      10.1177/0194599817691955. Epub 2017 Feb 14.