PMID- 35848772
OWN - NLM
STAT- MEDLINE
DCOM- 20230316
LR  - 20230523
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 133
IP  - 4
DP  - 2023 Apr
TI  - Proximal Scar Progression in Idiopathic Subglottic Stenosis After Wedge Excision: 
      Does it Happen?
PG  - 875-882
LID - 10.1002/lary.30292 [doi]
AB  - OBJECTIVE: To compare the incidence of glottic stenosis in idiopathic subglottic 
      stenosis (iSGS) patients with no prior surgical intervention to those with a 
      history of endoscopic dilation and characterize the incidence of glottic 
      involvement, changes in scar length, and progression of scar toward glottis 
      following laser wedge excision (LWE). METHODS: A retrospective review of iSGS 
      patients who underwent LWE between 2002 and 2021 was performed. Patients without 
      prior airway surgery were labeled LWE primary (LWEP) and operative findings for 
      LWEP patients were reviewed for glottic involvement, scar length (D(L) ), and 
      distance from the glottis to superior-most aspect of scar (D(GS) ). Rates (in 
      mm/procedure) of D(DeltaL) , reflecting an increase in length, and D(-DeltaGS) , 
      reflecting proximal migration, were calculated by dividing D(DeltaL) and D(-DeltaGS) by 
      the number of LWE procedures. RESULTS: 213 iSGS patients underwent LWE, with 132 
      being LWEP patients. LWEP had a lower incidence of baseline glottic involvement 
      (n = 6, 4.5%) than LWE secondary (LWES; n = 6, 7.5%). Four new cases of glottic 
      involvement were noted in LWEP patients following LWE, with only one being 
      clinically significant resulting in permanently decreased vocal fold mobility. 
      With each procedure, scar length increased by 1.0 mm and D(GS) decreased by 
      0.7 mm, reflecting a migration or decrease in D(GS) of 9.5% with each procedure 
      with respect to initial D(GS) . Overall rates of glottic stenosis following 
      operations were similar between LWEP and LWES cohorts, 7.6% and 7.5% 
      respectively. CONCLUSION: There appears to be a low risk of glottic involvement 
      resulting from the LWE procedure in iSGS patients. LEVEL OF EVIDENCE: 4 
      Laryngoscope, 133:875-882, 2023.
CI  - (c) 2022 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Xie, Katherine Z
AU  - Xie KZ
AUID- ORCID: 0000-0003-0007-5136
AD  - Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
FAU - Bowen, Andrew Jay
AU  - Bowen AJ
AUID- ORCID: 0000-0002-6542-7932
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Richards, Bradley A
AU  - Richards BA
AUID- ORCID: 0000-0002-3520-1932
AD  - Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
FAU - Aden, Aisha
AU  - Aden A
AUID- ORCID: 0000-0002-8024-3015
AD  - Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
FAU - Wiedermann, Joshua
AU  - Wiedermann J
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Rutt, Amy L
AU  - Rutt AL
AUID- ORCID: 0000-0002-7704-6328
AD  - Department of Otorhinolaryngology/Audiology, Mayo Clinic, Jacksonville, Florida, 
      U.S.A.
FAU - Vassallo, Robert
AU  - Vassallo R
AD  - Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Edell, Eric S
AU  - Edell ES
AD  - Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Bayan, Semirra L
AU  - Bayan SL
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Kasperbauer, Jan L
AU  - Kasperbauer JL
AUID- ORCID: 0000-0003-2345-1157
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
FAU - Ekbom, Dale C
AU  - Ekbom DC
AUID- ORCID: 0000-0001-8770-8463
AD  - Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, 
      Minnesota, U.S.A.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220718
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Humans
MH  - Constriction, Pathologic/complications
MH  - *Cicatrix/etiology/complications
MH  - *Laryngostenosis/epidemiology/etiology/surgery
MH  - Endoscopy/methods
MH  - Glottis/surgery/pathology
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - idiopathic subglottic stenosis
OT  - laser wedge excision
EDAT- 2022/07/19 06:00
MHDA- 2023/03/17 06:00
CRDT- 2022/07/18 08:32
PHST- 2022/05/15 00:00 [revised]
PHST- 2022/03/23 00:00 [received]
PHST- 2022/06/16 00:00 [accepted]
PHST- 2022/07/19 06:00 [pubmed]
PHST- 2023/03/17 06:00 [medline]
PHST- 2022/07/18 08:32 [entrez]
AID - 10.1002/lary.30292 [doi]
PST - ppublish
SO  - Laryngoscope. 2023 Apr;133(4):875-882. doi: 10.1002/lary.30292. Epub 2022 Jul 18.