Abstract:
Objectives: Laryngotracheal stenosis (LTS) is characterized by an abnormal decrease in the upper airway diameter. The pulmonary function test (PFT) is an effective adjunctive diagnostic tool for upper airway obstruction. LTS can be managed with either open surgery or less invasive endoscopic approaches, among which endoscopic balloon dilation is the main method; this may include concurrent intralesional steroid injection (ILSI), which has the potential of improving the outcomes. However, the effectiveness of ILSI is unclear. We aimed to compare the improvement in PFT parameters among patients with acquired LTS following endoscopic balloon dilation who received and did not receive ILSIs. We also compared the recurrence times and rates between the 2 patient cohorts. Methods: We retrospectively collected data regarding pre- and postoperative PFTs, as well as inter-dilation interval records, obtained between June 2015 and April 2020. Results: We included 34 patients with acquired etiologies. The most common cause of stenosis was intubation (52.9%), followed by trauma (29.4%). Further, 52.9% of the patients received ILSIs. Symptom recurrence was reported in 23 (67.6%) cases, with no significant between-group difference -0.1389 [95% confidence interval (CI): -0.4483, 0.1705]. The mean (standard deviation) duration of the first reintervention was 8.62 (8.00) and 7.38 (3.20) months among patients who did and did not receive ILSIs, respectively (mean difference -1.23, P = .614, 95% CI -6.30, 3.84). Conclusion: Our findings indicated that PFT parameters improved following endoscopic balloon dilation, with forced expiratory volume in 1 second being significantly higher with concurrent ILSI. However, there was no between-method difference in the treatment effectiveness. Additionally, the restenosis recurrence rate was consistent with that reported in the literature.
摘要:
目的:喉气管狭窄(LTS)的特征是上气道直径异常减小。肺功能测试(PFT)是上呼吸道阻塞的有效辅助诊断工具。LTS可以通过开放手术或侵入性较小的内窥镜方法进行管理,其中内窥镜球囊扩张是主要方法;这可能包括同时病灶内注射类固醇(ILSI),有可能改善结果。然而,ILSI的有效性尚不清楚。我们旨在比较接受和未接受ILSI的内窥镜球囊扩张术后获得LTS的患者PFT参数的改善。我们还比较了两个患者队列之间的复发时间和发生率。方法:我们回顾性收集了关于术前和术后PFTs的数据,以及扩张间隔记录,在2015年6月至2020年4月期间获得。结果:我们纳入了34例获得性病因患者。狭窄的最常见原因是插管(52.9%),其次是创伤(29.4%)。Further,52.9%的患者接受了ILSI。23例(67.6%)出现症状复发,组间无显著差异-0.1389[95%置信区间(CI):-0.4483,0.1705]。在接受和未接受ILSI的患者中,首次再干预的平均(标准差)持续时间为8.62(8.00)和7.38(3.20)个月,分别(平均差-1.23,P=.614,95%CI-6.30,3.84)。结论:我们的发现表明内镜下球囊扩张后PFT参数改善,在并发ILSI的情况下,1秒内用力呼气量明显更高。然而,治疗效果无方法间差异.此外,再狭窄复发率与文献报道一致.