PMID- 29756352
OWN - NLM
STAT- MEDLINE
DCOM- 20190304
LR  - 20190304
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 128
IP  - 10
DP  - 2018 Oct
TI  - Outcomes after cricotracheal resection for idiopathic subglottic stenosis.
PG  - 2268-2272
LID - 10.1002/lary.27263 [doi]
AB  - OBJECTIVES: Idiopathic subglottic stenosis (iSGS) is a rare disease in which 
      patients develop airway narrowing and dyspnea from relapsing subglottic and 
      tracheal granulation and scar tissue that narrows the airway. Definitive 
      management has involved surgical resection and reconstruction of the subglottis 
      and trachea. However, treatment options remain highly variable at different 
      institutions. Here, we present our outcomes and experience after cricotracheal 
      resection (CTR) for iSGS at a high-volume tertiary care center. METHODS: A review 
      of one surgeon's experience with a population of iSGS patients who underwent CTR 
      between the years 1999 and 2017. The diagnosis of iSGS was one of exclusion and 
      was based on history and microlaryngoscopy and bronchoscopy exams. Recurrence of 
      subglottic stenosis was evaluated using Kaplan-Meier survival estimate analysis. 
      RESULTS: Sixty-one patients met criteria for iSGS and underwent CTR. Our 
      population was 97% female and had an average of 4.3 balloon dilations prior to 
      CTR. Mean follow-up time after CTR was 7.14 years. Eight (13%) patients developed 
      recurrence of subglottic stenosis after CTR. Mean and median time to recurrence 
      after CTR was 12.5 years and 14.1 years, respectively. CONCLUSION: Cricotracheal 
      resection is associated with a small, long-term recurrence rate of stenosis. It 
      remains an important option for individuals with refractory iSGS. It may be 
      reasonable to consider early CTR in the management of certain patients with iSGS. 
      Further research should investigate risk factors that predispose patients to 
      recurrence after CTR. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:2268-2272, 2018.
CI  - (c) 2018 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Carpenter, Patrick S
AU  - Carpenter PS
AUID- ORCID: 0000-0002-8942-4197
AD  - Department of Surgery Division of Otolaryngology-Head and Neck Surgery, 
      University of Utah Health System, Salt Lake City, Utah, U.S.A.
FAU - Pierce, Jenny L
AU  - Pierce JL
AD  - Department of Surgery Division of Otolaryngology-Head and Neck Surgery, 
      University of Utah Health System, Salt Lake City, Utah, U.S.A.
FAU - Smith, Marshall E
AU  - Smith ME
AD  - Department of Surgery Division of Otolaryngology-Head and Neck Surgery, 
      University of Utah Health System, Salt Lake City, Utah, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20180514
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cricoid Cartilage/*surgery
MH  - Dilatation/adverse effects/methods
MH  - Female
MH  - Humans
MH  - Laryngoscopy
MH  - Laryngostenosis/*surgery
MH  - Male
MH  - Middle Aged
MH  - Otorhinolaryngologic Surgical Procedures/adverse effects/*methods
MH  - Postoperative Complications/epidemiology
MH  - Recurrence
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Tertiary Care Centers
MH  - Trachea/*surgery
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Tracheal
OT  - cricotracheal
OT  - idiopathic
OT  - resection
OT  - stenosis
OT  - subglottic
EDAT- 2018/05/15 06:00
MHDA- 2019/03/05 06:00
CRDT- 2018/05/15 06:00
PHST- 2017/10/18 00:00 [received]
PHST- 2018/03/18 00:00 [revised]
PHST- 2018/04/06 00:00 [accepted]
PHST- 2018/05/15 06:00 [pubmed]
PHST- 2019/03/05 06:00 [medline]
PHST- 2018/05/15 06:00 [entrez]
AID - 10.1002/lary.27263 [doi]
PST - ppublish
SO  - Laryngoscope. 2018 Oct;128(10):2268-2272. doi: 10.1002/lary.27263. Epub 2018 May 
      14.