Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A.
Long School of Medicine, UT Health San Antonio, San Antonio, Texas, U.S.A.
Laryngoscope. 2021 Aug;131(8):1816-1820. doi: 10.1002/lary.29085. Epub 2020 Sep 9.
OBJECTIVES/HYPOTHESIS: We sought to characterize rates of progression to posterior glottic stenosis (PGS) from autoimmune or idiopathic subglottic stenosis.
This was a retrospective review.
Patients from a tertiary-care laryngology practice over a 10-year period with autoimmune or idiopathic subglottic stenosis (SGS) were included. Patients with a history of prolonged intubation or other causes of iatrogenic stenosis were excluded. PGS was confirmed on videostrobolaryngoscopy recordings by a fellowship-trained laryngologist. PGS type (1-4) was also recorded. Demographic information was recorded, and if applicable, autoimmune disease type was specified. Time until PGS was recorded along with the number of interventions. Chi-squared analysis was used to compare PGS in autoimmune and idiopathic SGS.
A total of 77 patients were identified with autoimmune (32 patients) or idiopathic (45 patients) subglottic stenosis. Autoimmune pathologies included systemic lupus erythematosus, granulomatosis with polyangiitis (GPA), rheumatoid arthritis, relapsing polychondritis, and sarcoidosis, with GPA the most common (14/32). Patients with autoimmune SGS had a higher rate of PGS (10 of 32) compared to idiopathic subglottic stenosis (1 of 45) for an odds ratio of 20 (95% CI: 2.4-166.4, P = .006). Patients with idiopathic SGS were more likely to be female (all 45 compared to 29/32 autoimmune, P = .07) and older (mean 53 (range 29-75) compared to 46 (20-82), P = .02).
In this large patient cohort, autoimmune SGS patients were found to have a higher likelihood of developing PGS compared to their idiopathic counterparts, suggesting that counseling for this progression may be warranted.
4 Laryngoscope, 131:1816-1820, 2021.
目的/假设：我们旨在描述自身免疫性或特发性声门下狭窄（SGS）进展为后声门狭窄（PGS）的速度。
这是一项回顾性研究。
本研究纳入了在一家三级护理喉科诊所就诊的 10 年间患有自身免疫性或特发性声门下狭窄（SGS）的患者。排除有长期插管或其他医源性狭窄原因的患者。通过由一名 fellowship 培训的喉镜医师在视频频闪喉镜记录中确认 PGS。还记录了 PGS 类型（1-4 型）。记录了人口统计学信息，如果适用，则指定了自身免疫性疾病类型。记录了 PGS 发生的时间以及干预的次数。使用卡方分析比较自身免疫性和特发性 SGS 中的 PGS。
共确定了 77 例自身免疫性（32 例）或特发性（45 例）声门下狭窄患者。自身免疫性病变包括系统性红斑狼疮、肉芽肿性多血管炎（GPA）、类风湿关节炎、复发性多软骨炎和结节病，其中 GPA 最常见（14/32）。与特发性声门下狭窄（45 例中仅有 1 例，1/45）相比，自身免疫性 SGS 患者的 PGS 发生率更高（32 例中有 10 例，OR 为 20，95%CI：2.4-166.4，P=0.006）。与特发性 SGS 患者相比，自身免疫性 SGS 患者更可能为女性（全部为 45 例，而自身免疫性患者为 29/32，P=0.07）和年龄更大（平均年龄为 53 岁（范围 29-75 岁）与 46 岁（20-82 岁），P=0.02）。
在这项大型患者队列研究中，与特发性 SGS 患者相比，自身免疫性 SGS 患者发生 PGS 的可能性更高，这表明可能需要为此类进展提供咨询。
4 级喉镜检查，131：1816-1820，2021 年。
