PDF(Pubmed)
Abstract：
OBJECTIVE: Surgical treatment for airway stenosis necessitates personalized techniques based on the stenosis location and length, leading to favourable surgical outcomes. However, there is limited literature on functional outcomes following laryngotracheal surgery with an adequate number of patients.
METHODS: We conducted a retrospective analysis of patients who underwent laryngotracheal surgery at the Department of Thoracic Surgery, Medical University of Vienna, from January 2017 to June 2021. The study included standardized functional assessments before and after surgery, encompassing spirometry, voice measurements, swallowing evaluation and subjective patient perception.
RESULTS: The study comprised 45 patients with an average age of 51.9 ± 15.9 years, of whom 89% were female, with idiopathic being the most common aetiology (67%). Procedures included standard cricotracheal resection in 11%, cricotracheal resection with dorsal mucosal flap in 49%, cricotracheal resection with dorsal mucosal flap and lateral cricoplasty in 24% and single-stage laryngotracheal reconstruction in 16%. There were no in-hospital mortalities or restenosis cases during the mean follow-up period of 20.8 ± 13.2 months. Swallowing function remained intact in all patients. Voice evaluations showed a decrease in fundamental vocal pitch [203 (81-290) Hz vs 150 (73-364) Hz, P < 0.001] and dynamic voice range (23.5 ± 5.8 semitones vs 17.8 ± 6.7 semitones, P < 0.001). However, no differences in voice volume were observed (60.0 ± 4.1 dB vs 60.2 ± 4.8 dB, P = 0.788). The overall predicted voice profile changed from R0B0H0 to R1B0H1.
CONCLUSIONS: Laryngotracheal surgery proves effective in fully restoring breathing capacity while preserving vocal function. Even in cases of high-grade and complex airway stenosis necessitating laryngotracheal reconstruction, favourable functional outcomes can be achieved.
METHODS: We conducted a retrospective analysis of patients who underwent laryngotracheal surgery at the Department of Thoracic Surgery, Medical University of Vienna, from January 2017 to June 2021. The study included standardized functional assessments before and after surgery, encompassing spirometry, voice measurements, swallowing evaluation and subjective patient perception.
RESULTS: The study comprised 45 patients with an average age of 51.9 ± 15.9 years, of whom 89% were female, with idiopathic being the most common aetiology (67%). Procedures included standard cricotracheal resection in 11%, cricotracheal resection with dorsal mucosal flap in 49%, cricotracheal resection with dorsal mucosal flap and lateral cricoplasty in 24% and single-stage laryngotracheal reconstruction in 16%. There were no in-hospital mortalities or restenosis cases during the mean follow-up period of 20.8 ± 13.2 months. Swallowing function remained intact in all patients. Voice evaluations showed a decrease in fundamental vocal pitch [203 (81-290) Hz vs 150 (73-364) Hz, P < 0.001] and dynamic voice range (23.5 ± 5.8 semitones vs 17.8 ± 6.7 semitones, P < 0.001). However, no differences in voice volume were observed (60.0 ± 4.1 dB vs 60.2 ± 4.8 dB, P = 0.788). The overall predicted voice profile changed from R0B0H0 to R1B0H1.
CONCLUSIONS: Laryngotracheal surgery proves effective in fully restoring breathing capacity while preserving vocal function. Even in cases of high-grade and complex airway stenosis necessitating laryngotracheal reconstruction, favourable functional outcomes can be achieved.
摘要：
背景：气道狭窄的外科治疗需要基于狭窄位置和长度的个性化技术，导致良好的手术效果。然而,关于喉气管手术后功能结局的文献有限,患者数量足够.
方法：我们对胸外科接受喉气管手术的患者进行了回顾性分析，维也纳医科大学,从2017年1月到2021年6月。该研究包括手术前后的标准化功能评估，包括肺活量测定，语音测量,吞咽评估，和患者的主观感知。
结果：该研究包括45名患者，平均年龄为51.9±15.9岁，其中89%是女性，特发性是最常见的病因（67%）。手术包括11%的标准环气管切除术(CTR)，背侧黏膜瓣的CTR为49%，背侧黏膜瓣和外侧环成形术的CTR为24%，单阶段喉气管重建占16%。在平均20.8±13.2个月的随访期内，没有住院死亡或再狭窄病例。所有患者的吞咽功能均保持完整。语音评估显示基本人声音高降低（203（81-290）Hz与150(73-364)Hz,p<0.001）和动态语音范围（23.5±5.8半音vs.17.8±6.7半音，p<0.001)。然而,没有观察到语音音量的差异（60.0±4.1dB与60.2±4.8dB,p=0.788）。总体预测语音配置文件从R0B0H0变为R1B0H1。
结论：喉气管手术证明在完全恢复呼吸能力的同时保持声带功能是有效的。即使在需要喉气管重建的高度和复杂的气道狭窄的情况下，可以实现良好的功能结果。
方法：我们对胸外科接受喉气管手术的患者进行了回顾性分析，维也纳医科大学,从2017年1月到2021年6月。该研究包括手术前后的标准化功能评估，包括肺活量测定，语音测量,吞咽评估，和患者的主观感知。
结果：该研究包括45名患者，平均年龄为51.9±15.9岁，其中89%是女性，特发性是最常见的病因（67%）。手术包括11%的标准环气管切除术(CTR)，背侧黏膜瓣的CTR为49%，背侧黏膜瓣和外侧环成形术的CTR为24%，单阶段喉气管重建占16%。在平均20.8±13.2个月的随访期内，没有住院死亡或再狭窄病例。所有患者的吞咽功能均保持完整。语音评估显示基本人声音高降低（203（81-290）Hz与150(73-364)Hz,p<0.001）和动态语音范围（23.5±5.8半音vs.17.8±6.7半音，p<0.001)。然而,没有观察到语音音量的差异（60.0±4.1dB与60.2±4.8dB,p=0.788）。总体预测语音配置文件从R0B0H0变为R1B0H1。
结论：喉气管手术证明在完全恢复呼吸能力的同时保持声带功能是有效的。即使在需要喉气管重建的高度和复杂的气道狭窄的情况下，可以实现良好的功能结果。
