Sittel C, Monnier P, Peretti G, Piazza C, Fiz I
Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Deutschland.
Ehemals CHUV Lausanne, Lausanne, Schweiz.
HNO. 2020 Jun;68(6):407-413. doi: 10.1007/s00106-020-00830-3.
In 2015, the European Laryngological Society (ELS) published a consensus paper in which a new classification system for laryngotracheal stenosis (LTS) was presented. This retrospective analysis investigates the classification's reliability and prognostic value regarding the outcome of surgical airway reconstruction in a pediatric population.
A total of 191 pediatric patients treated with cricotracheal or segmental resection were included. The ELS score was retrospectively calculated using information on the degree of stenosis, number of involved subsites, and presence of significant comorbidity. Reliability and prognostic value for airway restoration, surgical complications, and need of additional treatment were analyzed.
Decannulation rate differed with regards to etiology (96% for acquired LTS, 86 and 87% for congenital and posttraumatic LTS, respectively). Decannulation was significantly more likely with 1-2 involved subsites than in LTS with 3-4 subsites (97 vs. 72%). The number of additional interventions after reconstruction was largely dependent on the number of involved subsites and the presence of significant comorbidity.
The ELS score for LTS permits prognostically reliable classification and is thus a valuable tool for decision making, counseling of patients and relatives, and comparing treatment outcomes.
2015年，欧洲喉科学会（ELS）发表了一篇共识论文，提出了一种新的喉气管狭窄（LTS）分类系统。本回顾性分析调查了该分类在儿科人群气道重建手术结果方面的可靠性和预后价值。
纳入了191例行环状气管或节段性切除术的儿科患者。使用关于狭窄程度、受累亚部位数量和显著合并症存在情况的信息，回顾性计算ELS评分。分析气道恢复、手术并发症和额外治疗需求的可靠性和预后价值。
拔管率因病因不同而有所差异（后天性LTS为96%，先天性和创伤后LTS分别为86%和87%）。1 - 2个受累亚部位的LTS比3 - 4个亚部位的LTS更有可能拔管（97%对72%）。重建后额外干预的次数在很大程度上取决于受累亚部位的数量和显著合并症的存在情况。
LTS的ELS评分允许进行预后可靠的分类，因此是决策、为患者及其亲属提供咨询以及比较治疗结果的有价值工具。
