Gnagi Sharon H, Howard Brittany E, Anderson Catherine, Lott David G
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Inside Story, Sydney, NSW, Australia.
Ann Otol Rhinol Laryngol. 2015 Sep;124(9):734-9. doi: 10.1177/0003489415582255. Epub 2015 Apr 24.
To report and compare patients' experiences with acquired subglottic stenosis (AS) versus idiopathic subglottic and tracheal stenosis (ISTS).
A survey was made available to patients with AS and ISTS. Results were analyzed for inter- and intragroup differences using a 2-tailed t test.
The study included 160 survey participants (AS n = 28; ISTS n = 132), with a predominance of female participants (82% AS, 98% ISTS). Acid reflux was the most prevalent comorbidity across groups (42%-43%). A significant difference in time to diagnosis was found between groups, with 32% of AS patients diagnosed within 3 months of symptom onset, compared to 2% with ISTS. A diagnosis delay greater than 18 months occurred for 58% of ISTS patients. There was no difference in treatment approach, with the most common treatment being balloon dilation, followed by laser dilation. Tracheal resection was performed in 36% of patients in both groups. Patient satisfaction with surgical outcomes was significantly higher after tracheal resection (76%) compared to other treatment modalities (39%).
ISTS remains a diagnostic challenge as highlighted by the delay in diagnosis compared to AS. There appears to be no historical or symptomatic factors specific to ISTS. Additionally, patients report increased satisfaction and symptom resolution after tracheal resection.
报告并比较获得性声门下狭窄(AS)与特发性声门下及气管狭窄(ISTS)患者的经历。
对AS和ISTS患者进行了一项调查。使用双尾t检验分析结果以比较组间和组内差异。
该研究纳入了160名调查参与者(AS组n = 28;ISTS组n = 132),女性参与者占多数(AS组82%,ISTS组98%)。胃酸反流是各组中最常见的合并症(42%-43%)。两组在诊断时间上存在显著差异,32%的AS患者在症状出现后3个月内被诊断出来,而ISTS患者中这一比例为2%。58%的ISTS患者诊断延迟超过18个月。治疗方法没有差异,最常见的治疗是球囊扩张,其次是激光扩张。两组中36%的患者接受了气管切除术。与其他治疗方式(39%)相比,气管切除术后患者对手术结果的满意度显著更高(76%)。
与AS相比,ISTS的诊断延迟突出表明其仍是一项诊断挑战。似乎没有特定于ISTS的病史或症状因素。此外,患者报告气管切除术后满意度提高且症状得到缓解。