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Idiopathic subglottic stenosis

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https://www.readbyqxmd.com/read/29756352/outcomes-after-cricotracheal-resection-for-idiopathic-subglottic-stenosis
#1
Patrick S Carpenter, Jenny L Pierce, Marshall E Smith
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...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29707509/idiopathic-subglottic-stenosis-techniques-and-results
#2
REVIEW
Andrea L Axtell, Douglas J Mathisen
Idiopathic subglottic stenosis is a rare condition of unknown etiology characterized by circumferential stenosis in the subglottic larynx and upper trachea. Historically, patients were treated with dilation or ablation, however this approach has proven to be largely palliative and often leads to recurrence and the need for tracheostomy. A single-staged laryngotracheal resection and reconstruction is now the preferred definitive treatment for idiopathic subglottic stenosis and can be performed with excellent patient outcomes and rare subsequent progression of the disease...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29643170/treatment-options-in-idiopathic-subglottic-stenosis-protocol-for-a-prospective-international-multicentre-pragmatic-trial
#3
Alexander Gelbard, Yu Shyr, Lynne Berry, Alexander T Hillel, Dale C Ekbom, Eric S Edell, Jan L Kasperbauer, David G Lott, Donald T Donovan, C Gaelyn Garrett, Guri Sandhu, James J Daniero, James L Netterville, Josh S Schindler, Marshall E Smith, Paul C Bryson, Robert R Lorenz, David O Francis
INTRODUCTION: Idiopathic subglottic stenosis (iSGS) is an unexplained progressive obstruction of the upper airway that occurs almost exclusively in adult, Caucasian women. The disease is characterised by mucosal inflammation and localised fibrosis resulting in life-threatening blockage of the upper airway. Because of high recurrence rates, patients with iSGS will frequently require multiple procedures following their initial diagnosis. Both the disease and its therapies profoundly affect patients' ability to breathe, communicate and swallow...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29627051/contemporary-management-of-idiopathic-laryngotracheal-stenosis
#4
REVIEW
Laura Donahoe, Shaf Keshavjee
Idiopathic laryngotracheal stenosis is a rare but well-described indication for subglottic tracheal resection. Initially described by Pearson in 1975, the 1-stage subglottic tracheal resection with reconstruction of the airway ensures preservation of the recurrent laryngeal nerves while resulting in an effective and durable repair of the stenosis.
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29513385/quality-of-life-metrics-correlate-with-disease-severity-in-idiopathic-subglottic-stenosis
#5
Matthew R Naunheim, Paul M Paddle, Inna Husain, Patcharamanee Wangchalabovorn, David Rosario, Ramon A Franco
OBJECTIVES: Idiopathic subglottic stenosis (ISGS) can have significant impacts on quality of life (QOL), but it remains unclear how patients' subjective responses correlate with objective measurement of disease severity. Peak expiratory flow percentage (PEF%) has been shown to be an effective measure of disease severity in subglottic stenosis. This study aims to identify the key QOL questions correlated with PEF% and proposes a statistical model for prediction of disease severity. METHODS: Patients with ISGS presenting to an academic laryngologist were included retrospectively from 2012 to 2016...
March 7, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29488498/-the-modern-approach-to-the-treatment-of-subglottic-laryngeal-stenosis
#6
A I Krukov, E A Kirasirova, O K Piminidi, R A Rezakov, N V Lafutkina, R F Mamedov
The objective of the present study was to optimize the treatment of patients with subglottic laryngeal stenosis. MATERIAL AND METHODS: We have examined a total of 14 patients presenting with subglottic laryngeal stenosis. The etiological factors and underlying conditions of laryngeal stenosis were the prolonged intubation in 4 patients, Wegener granulomatosis in 6 patients, and idiopathic stenosis of the larynx in 4 patients. All the patients underwent balloon dilatation with the application of the video endoscopic technique...
2018: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/29327045/serial-in-office-intralesional-steroid-injections-in-airway-stenosis
#7
Caitlin Bertelsen, Hagit Shoffel-Havakuk, Karla O'Dell, Michael M Johns, Lindsay S Reder
Importance: Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis (SGS/PTS). Its major limitation is restenosis requiring repeated surgery. Intralesional steroid injection (ISI) is a promising adjunctive treatment aimed at prolonging the effects of dilation. Objective: To evaluate the association of serial in-office ISI after endoscopic dilation with surgery-free interval (SFI) in adults with SGS/PTS. Design, Setting, and Participants: A retrospective study of adults with SGS/PTS who underwent at least 2 consecutive in-office ISI at the University of Southern California, Keck School of Medicine, over a 3-year period was conducted...
March 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28990664/hormone-receptors-analysis-in-idiopathic-progressive-subglottic-stenosis
#8
Ivana Fiz, Zeid Bittar, Cesare Piazza, Jan Constantin Koelmel, Federico Gatto, Diego Ferone, Francesco Fiz, Diana Di Dio, Alexander Bosse, Giorgio Peretti, Christian Sittel
OBJECTIVE: Idiopathic subglottic stenosis predominantly affects fertile and perimenopausal women. Estrogens and/or progesterone have been proposed as mediators of its pathogenesis by stimulating collagen deposition within the upper airway. We evaluated the presence and expression of estrogen-alpha (ER-α), estrogen-beta (ER-β), and progesterone receptors (PR) in idiopathic stenotic patients. STUDY DESIGN: A retrospective analysis on 42 surgical specimens from idiopathic stenosis female patients (mean age, 52...
February 2018: Laryngoscope
https://www.readbyqxmd.com/read/28988454/awake-serial-intralesional-steroid-injections-without-surgery-as-a-novel-targeted-treatment-for-idiopathic-subglottic-stenosis
#9
Ramon A Franco, Inna Husain, Lindsay Reder, Paul Paddle
OBJECTIVES/HYPOTHESIS: The fibrotic/erythematous appearance of the subglottis in idiopathic subglottic stenosis (iSGS) hints that it might respond to repeated intralesional steroid treatment similar to keloids. STUDY DESIGN: Retrospective cohort study. METHODS: Thirteen iSGS subjects (six treated in-office with serial intralesional steroid injections [SILSI] versus seven treated endoscopically in the operating room [OR] followed by awake SILSI) between October 2011 and April 2017...
March 2018: Laryngoscope
https://www.readbyqxmd.com/read/28581185/serial-office-based-steroid-injections-for-treatment-of-idiopathic-subglottic-stenosis
#10
Matthew R Hoffman, Adam R Coughlin, Seth H Dailey
OBJECTIVES/HYPOTHESIS: Current treatment options for idiopathic subglottic stenosis include endoscopic interventions, resection, and tracheotomy. Recently, serial office-based steroid injections were proposed as an alternative that may stabilize or induce regression of airway stenosis without the need for repeated operations. Procedure completion rate, pain, complications, effect on stenosis, time since the last operation, and limitations have not been described. STUDY DESIGN: Retrospective case series...
November 2017: Laryngoscope
https://www.readbyqxmd.com/read/28485188/quantification-of-inflammatory-markers-in-laryngotracheal-stenosis
#11
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/28457219/commentary-on-menapace-et-al-idiopathic-subglottic-stenosis-long-term-outcomes-of-open-surgical-techniques
#12
Ahmed M S Soliman
No abstract text is available yet for this article.
May 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28243785/idiopathic-subglottic-stenosis-an-epidemiological-single-center-study
#13
Maria Tyse Aarnæs, Leiv Sandvik, Kjell Brøndbo
A retrospective epidemiological study of patients treated for idiopathic subglottic stenosis (ISS) during 2003-2013 at Oslo University Hospital, Rikshospitalet, was undertaken to assess its incidence, management and treatment outcomes. Out of a total of 123 patients with subglottic stenosis (84 female, 39 men), 38 patients were diagnosed with ISS, all of whom were female. Of these, 23 lived in the South-Eastern Norway Regional Health Authority, representing an incidence of 0.2 per 100,000 (95% CI 0.13-0.3) in this region of 2...
May 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28241174/endoscopic-management-of-subglottic-stenosis
#14
Aaron J Feinstein, Alex Goel, Govind Raghavan, Jennifer Long, Dinesh K Chhetri, Gerald S Berke, Abie H Mendelsohn
Importance: Optimal management of subglottic stenosis has not been established. Endoscopic techniques include balloon dilation, radial incisions with carbon dioxide laser or cold knife, and combinations of techniques. Adjunctive measures include mitomycin application and glucocorticoid injection. Objective: To determine whether surgical technique or adjunctive measures are associated with duration between surgical procedures. Design, Setting, and Participants: Adult patients with subglottic stenosis treated endoscopically between 1995-2015 at a quaternary academic medical center were identified...
May 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28195821/idiopathic-subglottic-stenosis-long-term-outcomes-of-open-surgical-techniques
#15
Deanna C Menapace, Mara C Modest, Dale C Ekbom, Eric J Moore, Eric S Edell, Jan L Kasperbauer
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...
May 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27882558/effects-of-voice-sparing-cricotracheal-resection-on-phonation-in-women
#16
Kristine Tanner, Christopher Dromey, Mark L Berardi, Lisa M Mattei, Jenny L Pierce, Jonathan J Wisco, Eric J Hunter, Marshall E Smith
INTRODUCTION: Individuals with idiopathic subglottic stenosis (SGS) are at risk for voice disorders prior to and following surgical management. This study examined the nature and severity of voice disorders in patients with SGS before and after a revised cricotracheal resection (CTR) procedure designed to minimize adverse effects on voice function. METHOD: Eleven women with idiopathic SGS provided presurgical and postsurgical audio recordings. Voice Handicap Index (VHI) scores were also collected...
September 2017: Laryngoscope
https://www.readbyqxmd.com/read/27864505/endoscopic-management-of-idiopathic-subglottic-stenosis
#17
Sepehr Shabani, Matthew R Hoffman, William T Brand, Seth H Dailey
OBJECTIVE: To describe a homogeneous idiopathic subglottic stenosis (ISS) population undergoing endoscopic balloon dilation and evaluate factors affecting inter-dilation interval (IDI). METHODS: Retrospective review of 37 patients. Co-morbidity prevalence versus normal population was evaluated using chi-square tests. Correlations were evaluated using Pearson product moment tests. Independent samples t tests/rank sum tests assessed differences between groups of interest...
February 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27772613/a-novel-technique-for-laryngotracheal-reconstruction-for-idiopathic-subglottic-stenosis
#18
Anna M Ciccone, Camilla Vanni, Giulio Maurizi, Antonio D'Andrilli, Stylianos Korasidis, Mohsen Ibrahim, Claudio Andreetti, Federico Venuta, Erino A Rendina
Idiopathic subglottic stenosis is the most challenging condition in the field of upper airway reconstruction. We describe a successful novel technique for enlarging the airway space at the site of the laryngotracheal anastomosis in very high-level reconstructions.
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27607884/-idiopathic-progressive-subglottic-stenosis-surgical-techniques
#19
REVIEW
K Hoetzenecker, T Schweiger, W Klepetko
Idiopathic subglottic stenosis is a disease characterized by slow, progressive scarring and constriction of the subglottic airway. It almost always occurs in females between the 3rd and 5th decade of life. Symptoms are frequently misinterpreted as asthma and patients are referred for endoscopic evaluation only when asthma medications fail to alleviate their symptoms. Treatment options can be divided into endoscopic and open surgical techniques. Microlaryngoscopic scar reduction by laser followed by balloon dilation usually delivers good short-term results...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27461046/endoscopic-treatment-of-idiopathic-subglottic-stenosis-with-digital-acublade-robotic-microsurgery-system
#20
Alfonso Fiorelli, Salvatore Mazzone, Giuseppe Costa, Mario Santini
Herein, we described a novel method as the use of AcuBlade robotic microsurgery system to manage idiopathic subglottic stenosis in a 73-y-old lady. Compared to traditional CO2 lasers, AcuBlade facilitated the scar resection by the generation of different shape of beams (straight, curved, or disk). The same setting used for phonomicrosurgery (1-mm beam length, power of 10 W and pulse duration of 0.05-s) allowed to obtain fast, long, and uniform cuts. In addition, the reduction of the number of laser passes over the same area prevented injury of adjacent tissue and thus reduced the risk of recurrence...
February 2018: Clinical Respiratory Journal
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