Accepted for Presentation at the 2012 Combined Otolaryngological Spring Meetings, April 18, 2012, San Diego, CA. Accepted for Presentation at the 2011 Annual Meeting of the Virginia Society of Otolaryngology, May 20, 2011, Norfolk, VA.
Modalities of treatment for laryngotracheal stenosis: The EVMS experience
Article first published online: 28 JUN 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 12, pages 3131–3136, December 2013
How to Cite
Sinacori, J. T., Taliercio, S. J., Duong, E. and Benson, C. (2013), Modalities of treatment for laryngotracheal stenosis: The EVMS experience. The Laryngoscope, 123: 3131–3136. doi: 10.1002/lary.24237
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 NOV 2013
- Article first published online: 28 JUN 2013
- Accepted manuscript online: 11 JUN 2013 04:17AM EST
- Manuscript Revised: 14 MAY 2013
- Manuscript Accepted: 14 MAY 2013
- Airway stenosis;
The aims of the study were to identify trends in surgical management of laryngotracheal stenosis (LTS) based on lesion location, as well as to recognize factors associated with recurrence and repeat surgical intervention.
The study is a retrospective review of all adult patients cared for at a tertiary care laryngology practice with a diagnosis of laryngotracheal stenosis between October 2001 and July 2010, following Institutional Review Board approval.
This study collectively measured demographics, comorbidities, etiologies, sites of stenoses, treatment modalities, and recurrences.
Incisions made with the carbon dioxide (CO2) laser were the most common modality of treatment; patients with multilevel tracheal stenosis were most likely to have undergone at least one operation in which the CO2 laser was used to make incisions (78.7%). Balloon dilation was most commonly employed in patients with multilevel tracheal stenosis (66.0%). Lowest rates of decannulation were identified in patients with a pure tracheal stenosis (23.1%). Patients presenting with multilevel tracheal stenosis underwent the most procedures (6.7). Supraglottic, glottic, and multilevel laryngeal stenosis recurred at the lowest rates. Patients suffering from diabetes mellitus recurred in an average period of 3.9 months, a shorter time frame than those without diabetes, who recurred every 10.5 months.
Laser incision and/or balloon dilation are most effective in treatment of pure glottic, subglottic, and tracheal stenosis. Multilevel tracheal stenosis warrants closer follow-up, and is more likely to require multiple procedures. Worsening stenosis despite endoscopic management warrants an open procedure. Diabetes is associated with an earlier recurrence of stenosis.
Level of Evidence
2b. Laryngoscope, 123:3131–3136, 2013