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Laryngotracheal stenosis

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https://www.readbyqxmd.com/read/29106861/laryngotracheal-reconstruction-and-swallowing-a-review
#1
REVIEW
Jennifer F Ha, Lynn Driver, David A Zopf
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29100647/subglottic-stenosis-in-granulomatosis-with-polyangiitis-the-role-of-laryngotracheal-resection
#2
Christina L Costantino, John L Niles, Cameron D Wright, Douglas J Mathisen, Ashok Muniappan
BACKGROUND: Granulomatosis with polyangiitis (GPA) is associated with development of subglottic stenosis in about one-fourth of all patients. Although endoscopic management is the primary treatment method for tracheobronchial stenosis, some patients have refractory disease, and tracheostomy is required. It is unclear if laryngotracheal resection and reconstruction (LTRR) can be safely performed in patients with GPA. METHODS: A retrospective review was performed of 11 patients with GPA undergoing LTRR...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29064319/short-versus-long-term-stenting-in-children-with-subglottic-stenosis-undergoing-laryngotracheal-reconstruction
#3
David F Smith, Alessandro de Alarcon, Niall D Jefferson, Meredith E Tabangin, Michael J Rutter, Robin T Cotton, Catherine K Hart
Objectives Suprastomal stents are routinely used in laryngotracheal reconstruction (LTR) to stabilize grafts and provide framework to sites of repair. However, the duration of stenting varies according to patient history and physician preference. We examined outcomes of short- versus long-term stenting in children with subglottic stenosis (SGS) undergoing LTR. Study Design Case series with chart review. Setting Tertiary care pediatric hospital. Subjects and Methods Thirty-six children <18 years old who underwent double-stage LTR for SGS from January 2012 to January 2015 were included...
October 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29050103/-laryngotracheal-stenosis-in-children
#4
G X Wang, J Zhao, J Zhang, X Ni
Laryngotracheal stenosis includes congenital laryngotracheal stenosis and secondary laryngotracheal stenosis. Congenital laryngotracheal anomalies are rare, accounting for 0.3%-1.0% of all laryngotracheal stenosis(LTS). Despite the management of pediatric LTS over the past 30 years had been considerable improved, primary surgery still failed in a significant number of complex LTS cases. In some severe LTS cases combined with glottic stenosis, the primary surgery failed around 30%, even with the latest available techniques...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29050090/-laryngotracheal-resection-and-reconstruction-for-the-treatment-of-acquired-laryngotracheal-stenosis
#5
L J Ma, Y Xiao, Q W Yang, J Wang
Objective: To analyze the efficacy of laryngotracheal resection and reconstruction for acquired laryngotracheal stenosis, and to discuss the prevention of complication. Methods: The clinical outcomes of seventy patients with acquired laryngotracheal stenosis, treated with laryngotracheal resection and reconstruction were retrospectively reviewed between January 2007 and December 2016. The degree of stenosis was classified according to Myer-Cotton classification as follows: grade Ⅱ(n=7), grade Ⅲ(n=38) and grade Ⅳ(n=27)...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29044543/investigating-the-effects-of-laryngotracheal-stenosis-on-upper-airway-aerodynamics
#6
Tracy Cheng, David Carpenter, Seth Cohen, David Witsell, Dennis O Frank-Ito
OBJECTIVE: Very little is known about the impact of laryngotracheal stenosis (LTS) on inspiratory airflow and resistance, especially in air hunger states. This study investigates the effect of LTS on airway resistance and volumetric flow across three different inspiratory pressures. METHODS: Head-and-neck computed tomography scans of 11 subjects from 2010 to 2016 were collected. Three-dimensional reconstructions of the upper airway from the nostrils to carina, including the oral cavity, were created for one subject with a normal airway and for 10 patients with LTS...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29038859/refashioned-lamb-tissue-as-an-animal-model-for-training-complex-techniques-of-laryngotracheal-stenosis-surgery
#7
Lluís Nisa, Pedro Teiga, Gustavo Barreto da Cunha, Biswanath Roy, Riza Onder Gunaydin, Kishore Sandu
Open reconstructive upper airway surgery for laryngotracheal stenosis (LTS), whether for subglottic or tracheal stenosis, constitutes a group of complex approaches. LTS requiring open reconstruction is overall rare and primarily performed at tertiary centres. This poses an obvious challenge for the acquisition and maintenance of surgical skills for this group of complex approaches. In this context, animal models provide a unique opportunity for open reconstructive airway surgery training. Such models ought to take into consideration ethical aspects, be easily available and easy to maintain, and have similar macroscopic anatomical features to the human laryngotracheal frame...
December 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28988443/effects-of-supramaximal-balloon-dilatation-pressures-on-adult-cricoid-and-tracheal-cartilage-a-cadaveric-study
#8
Venkata S P B Durvasula, Sara C Shalin, Ozlem E Tulunay-Ugur, James Y Suen, Gresham T Richter
OBJECTIVES/HYPOTHESIS: Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings. STUDY DESIGN: Prospective cadaveric study. METHODS: Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28949246/a-case-series-of-the-probability-density-and-cumulative-distribution-of-laryngeal-disease-in-a-tertiary-care-voice-center
#9
Jaime de la Fuente, C Gaelyn Garrett, Robert Ossoff, Kim Vinson, David O Francis, Alexander Gelbard
OBJECTIVE: To examine the distribution of clinic and operative pathology in a tertiary care laryngology practice. METHODS: Probability density and cumulative distribution analyses (Pareto analysis) was used to rank order laryngeal conditions seen in an outpatient tertiary care laryngology practice and those requiring surgical intervention during a 3-year period. RESULTS: Among 3783 new clinic consultations and 1380 operative procedures, voice disorders were the most common primary diagnostic category seen in clinic (n = 3223), followed by airway (n = 374) and swallowing (n = 186) disorders...
November 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28940431/targeting-metabolic-abnormalities-to-reverse-fibrosis-in-iatrogenic-laryngotracheal-stenosis
#10
Michael K Murphy, Kevin M Motz, Dacheng Ding, Linda Yin, Madhavi Duvvuri, Michael Feeley, Alexander T Hillel
OBJECTIVE: Management of laryngotracheal stenosis (LTS) remains primarily surgical, with a critical need to identify targets for adjuvant therapy. Laryngotracheal stenosis scar fibroblasts exhibit a profibrotic phenotype with distinct metabolic shifts, including an increased glycolysis/oxidative phosphorylation ratio. This study examines the effects of the glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON) on collagen production, gene expression, proliferation, and metabolism of human LTS-derived fibroblasts in vitro...
September 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28934345/mesenchymal-stem-cell-therapy-for-laryngotracheal-stenosis-a-systematic-review-of-preclinical-studies
#11
REVIEW
Kathrine Kronberg Jakobsen, Christian Grønhøj, David H Jensen, Anne Fischer-Nielsen, Thomas Hjuler, Christian von Buchwald
BACKGROUND: Laryngotracheal stenosis (LTS) can be either congenital or acquired. Laryngeal stenosis is most often encountered after prolonged intubation. The mechanism for stenosis following intubation is believed to be hypertrophic scarring. Mesenchymal stem cells (MSCs) therapy has shown promising results in regenerative medicine. We aimed to systematically review the literature on MSC therapy for stenosis of the conductive airways. METHODS: PubMed, EMBASE, Google Scholar and the Cochrane Library were systematically searched from January 1980-January 2017 with the purpose of identifying all studies addressing the effect of MSC therapy on the airway...
2017: PloS One
https://www.readbyqxmd.com/read/28929076/role-of-topical-medication-in-prevention-of-post-extubation-subglottic-stenosis
#12
Saravanam Prasanna Kumar, Arunachalam Ravikumar, Johnson Thanka
Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28921522/extraluminal-biodegradable-splint-to-treat-upper-airway-anterior-malacia-a-preclinical-proof-of-principle
#13
François Gorostidi, Cécile Courbon, Marco Burki, Antoine Reinhard, Kishore Sandu
OBJECTIVE: Upper airway malacia highly complicates the treatment of benign laryngotracheal stenosis, and no ideal option is available to date. We here explore the use of extraluminal biodegradable splints in an animal model of long-segment anterior tracheomalacia (TM). We show the efficacy, as well as the tissue tolerance, of a custom-made biodegradable extraluminal device surgically inserted around the trachea. STUDY DESIGN: Preclinical animal study. METHODS: Anterior TM was induced in rabbits through an anterior neck approach by removing eight consecutive anterior tracheal rings without damaging the underlying mucosa...
September 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28715559/interferon-%C3%AE-treatment-of-human-laryngotracheal-stenosis-derived-fibroblasts
#14
Kevin Motz, Idris Samad, Linda X Yin, Michael K Murphy, Madhavi Duvvuri, Dacheng Ding, Alexander T Hillel
Importance: Laryngotracheal stenosis (LTS) is a fibroproliferative disorder of the glottis, subglottis, and trachea. In models of fibrosis from other organ systems, the CD4+ T-cell response has been shown to regulate extracellular matrix deposition. Specifically, helper T cell 2 (TH2) promotes fibrosis, whereas TH1 and associated cytokines have been shown to be antifibrotic. However, this antifibrotic effect of the TH1 response has not been demonstrated in LTS. Objective: To determine whether the TH1 cytokine interferon-γ inhibits the function of LTS-derived fibroblasts in vitro...
November 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28713710/the-healing-effect-of-conditioned-media-and-bone-marrow-derived-stem-cells-in-laryngotracheal-stenosis-a-comparison-in-experimental-dog-model
#15
Kamyar Iravani, Arash Sobhanmanesh, Mohammad Javad Ashraf, Seyed Basir Hashemi, Davood Mehrabani, Shahrokh Zare
BACKGROUND: Differences in causes, severities, areas of stenosis, and the association with swallowing and phonation of larynx and trachea can result into Laryngotracheal stenosis (LTS).This study evaluated the healing effect of bone marrow stem cells (BMSCs) in experimentally induced LTS dog model. METHODS: Seven dogs were enrolled. BMSCs were isolated from proximal humerus and shoulder of a dog and cultured in media containing alpha minimal essential medium, fetal bovine serum, penicillin and streptomycin, and L-glutamine...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28675094/effect-of-increased-body-mass-index-on-complication-rates-during-laryngotracheal-surgery-utilizing-jet-ventilation
#16
Rachel A Barry, Daniel S Fink, Dusty Cole Pourciau, Kasey Hayley, Rachael Lanius, Schuylor Hayley, Eddy Sims, Andrew J McWhorter
Objective Jet ventilation has been used for >30 years as an anesthetic modality for laryngotracheal surgery. Concerns exist over increased risk with elevated body mass index (BMI). We reviewed our experience using jet ventilation for laryngotracheal stenosis to assess for complication rates with substratification by BMI. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods A total of 126 procedures with jet ventilation were identified from October 2006 to December 2014...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28638421/item-selection-and-content-validity-of-the-risk-factors-of-post-intubation-tracheal-stenosis-observation-questionnaire-for-icu-admitted-patients
#17
Roya Farzanegan, Behrooz Farzanegan, Maryam Alehashem, Mahdi Zangi, Sharareh R Niakan Kalhori, Kambiz Sheikhy, Habib Emami, Mohammad Behgam Shadmehr
BACKGROUND: Laryngotracheal stenosis as a late complication of prolonged endotracheal intubation is a life-threatening event. In order to determine the related risk factors for this complication, which may vary among different countries, designing a valid questionnaire is necessary. The aim of this study was to select the items and evaluate the face and content validities of a questionnaire developed for assessment of risk factors of post-intubation tracheal stenosis (PITS) in patients admitted in the intensive care unit...
2017: Tanaffos
https://www.readbyqxmd.com/read/28619544/changes-in-tracheostomy-and-intubation-related-tracheal-stenosis-implications-for-surgery
#18
Samuel S Kim, Zain Khalpey, Charles Hsu, Alex G Little
BACKGROUND: This study sought to identify the changing characteristic patterns and locations of stenosis after tracheostomy or intubation and to assess the risk factors associated with perioperative complication and restenosis after primary resection and reconstruction. METHODS: A retrospective review was performed (January /2012 to March 2015) on patients treated at the University of Arizona Medical Center (Tucson, Arizona) who had symptomatic tracheal stenosis secondary to prolonged intubation or tracheostomy...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28485188/quantification-of-inflammatory-markers-in-laryngotracheal-stenosis
#19
COMPARATIVE STUDY
Kevin M Motz, Linda X Yin, Idris Samad, Dacheng Ding, Michael K Murphy, Madhavi Duvvuri, Alexander T Hillel
Objectives (1) Develop a novel method for serial assessment of gene and protein expression in laryngotracheal stenosis (LTS). (2) Assess cytokine expression and determine an immunophenotype in LTS. Study Design A matched comparison of endolaryngeal brush biopsy samples from laryngotracheal scar and normal airway. Setting Tertiary care hospital, 2015-2016. Methods Brush biopsy specimens of laryngotracheal scar and normal trachea were obtained from 17 patients with LTS at the time of operating room dilation and were used for protein and RNA extraction...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28480810/traumatic-laryngotracheal-stenosis-treated-by-hyoid-sternohyoid-osseomuscular-flap-combined-with-xenogenic-acellular-dermal-matrix-a-case-report-and-literature-review
#20
Hang Yang, Zhe Chen, Shui-Hong Zhou, Qin-Yin Wang, Li-Xia Weng, Fang Wang, Ting-Ting Wu, Min-Li Zhou, Yang-Yang Bao
Objective The treatment of laryngotracheal stenosis is a major therapeutic challenge. Various treatments include observation, medical management, and surgical management. The most effective surgical management is resection and reconstruction. To the authors' knowledge, no reports have described the use of xenogenic acellular dermal matrix (ADM) for laryngotracheal stenosis. Methods A 27-year-old man presented with hemoptysis of the neck due to a traffic accident. Emergency orotracheal intubation was performed...
January 1, 2017: Journal of International Medical Research
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