Mirmozaffari Yasine, Ghodke Ameer, Shah Rupali N, Buckmire Robert A
University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A.
Department of Otolaryngology/Head and Neck Surgery, UNC Hospitals, Chapel Hill, North Carolina, U.S.A.
Laryngoscope. 2024 Apr;134(4):1769-1772. doi: 10.1002/lary.31080. Epub 2023 Oct 3.
OBJECTIVES/HYPOTHESIS: The aim was to assess changes in physical parameters of subglottic stenosis (SGS) following serial endoscopic surgical intervention.
This was a retrospective chart review.
A retrospective review of 52 idiopathic subglottic stenosis (iSGS) patients undergoing multiple endoscopic (excision/dilation) procedures between 2014 and 2022 was completed. Parameters including proximal stenosis distance from the vocal process and total stenosis length collected intraoperatively were compared over serial treatments. Differences between patient variables affecting distances from the vocal process and mean stenosis length were statistically analyzed utilizing nonparametric estimators including the Mann Whitney U, Fisher exact, and linear regression models.
For the cohort of iSGS patients (N = 52), the mean age was 55.1 (±15.1). The patients were predominantly female (96.2%) and Caucasian (84.6%). Patients underwent an average of 3.4 (±1.3) endoscopic procedures for long-term treatment of iSGS (range: 1 to 5 procedures). Patients undergoing a total of two (2) total procedures within the data collection window demonstrated a statistically significant decrease in mean stenosis length between the first and second procedures (p = 0.014). Changes in distance of the stenosis from the glottis was not found to be statistically significant (p = 0.833). There was a statistically significant decrease in mean length of stenosis from the 1st to the 2nd procedure by approximately 0.11 cm (p = 0.0003). No additional statistically significant differences in stenosis length or location were detected.
Serial endoscopic excision/dilation procedures (the mainstay of iSGS surgical management) do not appear to significantly lengthen intraluminal stenosis nor change the distance of the stenosis from the glottis.
4 Laryngoscope, 134:1769-1772, 2024.
目的/假设：本研究旨在评估连续内镜手术干预后声门下狭窄（SGS）物理参数的变化。
这是一项回顾性病历审查。
对2014年至2022年间接受多次内镜（切除/扩张）手术的52例特发性声门下狭窄（iSGS）患者进行回顾性研究。比较术中收集的包括距声带突近端狭窄距离和总狭窄长度等参数在连续治疗中的变化。利用非参数估计方法（包括曼-惠特尼U检验、费舍尔精确检验和线性回归模型）对影响距声带突距离和平均狭窄长度的患者变量之间的差异进行统计学分析。
对于iSGS患者队列（N = 52），平均年龄为55.1（±15.1）岁。患者以女性为主（96.2%），白种人占84.6%。患者平均接受3.4（±1.3）次内镜手术用于iSGS的长期治疗（范围：1至5次手术）。在数据收集窗口内总共接受两次手术的患者，第一次和第二次手术之间的平均狭窄长度有统计学意义的下降（p = 0.014）。狭窄部位距声门的距离变化无统计学意义（p = 0.833）。从第一次手术到第二次手术，狭窄平均长度有统计学意义的下降，约0.11 cm（p = 0.0003）。未检测到狭窄长度或位置的其他统计学显著差异。
连续内镜切除/扩张手术（iSGS手术治疗的主要方法）似乎不会显著延长管腔内狭窄，也不会改变狭窄部位距声门的距离。
4 喉镜，134:1769 - 1772，2024年。
