Abstract：
OBJECTIVE: Analyze the duration of symptom-free intervals following laser wedge excision (LWE) for recurrent idiopathic subglottic stenosis (iSGS). Secondary aim includes evaluating the influence of patient-related or disease factors.
METHODS: Retrospective review.
METHODS: Tertiary center.
METHODS: Review of iSGS patients who underwent LWE between 2002 and 2021. LWE patients without prior airway surgery were labeled LWE primary (LWEP) and those with prior history of dilation were labeled LWE secondary (LWES). A conditional frailty repeated events model was used to analyze the median time to recurrence (MTR) for each nth recurrence. Secondary analysis included stratification by use of medical therapy and initial preoperative characteristics of scar (Myer-Cotton grade, distance between the glottis and superior-most aspect of scar, DGS; length of scar, DL).
RESULTS: Two hundred and ten iSGS patients underwent LWE (131 LWEP, 79 LWES). The proportion of patients experiencing at least 1, 3, 6, and 12 recurrences, respectively, was 68.0% (n = 143), 40.7% (n = 85), 20.0% (n = 42), and 5.2% (n = 11). There was exponential time-shortening from the 1st to 12th recurrence (P < .0001). While MTR was 4.1 years after the first LWE, this fell to 2.8, 1.7, 1.0, and 0.7 years for the 2nd, 3rd, 6th, and 12th recurrences. Furthermore, LWEP patients experienced longer MTR than LWES counterparts within the first 6 recurrences (P < .01). There was no significant relationship between intersurgical interval and medication adherence, DL, DGS, or grade for recurrences beyond the first (P = .207, P = .20, P = .43, P = .16).
CONCLUSIONS: Symptom-free intervals in iSGS shorten with each subsequent recurrence and LWE. The difference in MTR between LWEP and LWES groups was significant within the first 6 recurrences with LWEP having longer MTR.
METHODS:
METHODS: Retrospective review.
METHODS: Tertiary center.
METHODS: Review of iSGS patients who underwent LWE between 2002 and 2021. LWE patients without prior airway surgery were labeled LWE primary (LWEP) and those with prior history of dilation were labeled LWE secondary (LWES). A conditional frailty repeated events model was used to analyze the median time to recurrence (MTR) for each nth recurrence. Secondary analysis included stratification by use of medical therapy and initial preoperative characteristics of scar (Myer-Cotton grade, distance between the glottis and superior-most aspect of scar, DGS; length of scar, DL).
RESULTS: Two hundred and ten iSGS patients underwent LWE (131 LWEP, 79 LWES). The proportion of patients experiencing at least 1, 3, 6, and 12 recurrences, respectively, was 68.0% (n = 143), 40.7% (n = 85), 20.0% (n = 42), and 5.2% (n = 11). There was exponential time-shortening from the 1st to 12th recurrence (P < .0001). While MTR was 4.1 years after the first LWE, this fell to 2.8, 1.7, 1.0, and 0.7 years for the 2nd, 3rd, 6th, and 12th recurrences. Furthermore, LWEP patients experienced longer MTR than LWES counterparts within the first 6 recurrences (P < .01). There was no significant relationship between intersurgical interval and medication adherence, DL, DGS, or grade for recurrences beyond the first (P = .207, P = .20, P = .43, P = .16).
CONCLUSIONS: Symptom-free intervals in iSGS shorten with each subsequent recurrence and LWE. The difference in MTR between LWEP and LWES groups was significant within the first 6 recurrences with LWEP having longer MTR.
METHODS:
摘要：
目的：分析复发性特发性声门下狭窄（iSGS）激光楔形切除术（LWE）后无症状间隔的持续时间。次要目标包括评估患者相关因素或疾病因素的影响。
方法：回顾性回顾。
方法：第三系中心。
方法：回顾在2002年至2021年期间接受LWE的iSGS患者。先前没有气道手术的LWE患者被标记为LWE原发性（LWEP），而先前有扩张史的患者被标记为LWE继发性（LWES）。条件性虚弱重复事件模型用于分析每n次复发的中位复发时间（MTR）。次要分析包括通过使用药物治疗和瘢痕的初始术前特征进行分层（Myer-Cotton级，声门和疤痕的最上层之间的距离，DGS;疤痕的长度,DL)。
结果：200名iSGS患者接受了LWE（131LWEP，79LWES）。经历至少1、3、6和12复发的患者比例，分别,为68.0%(n=143)，40.7%(n=85)，20.0%（n=42），5.2%(n=11)。从第1到第12次复发，时间呈指数级缩短（P<0.0001）。虽然地铁在第一次LWE后4.1年，第二次下降到2.8年、1.7年、1.0年和0.7年，3rd,6th,和第12次复发。此外，在前6次复发中，LWEP患者的MTR比LWES患者长（P<0.01）。术中间隔时间与服药依从性无显著关系,DL,DGS,或等级超过第一个（P=0.207，P=0.20，P=0.43，P=0.16）。
结论：iSGS中的无症状间隔随着每次复发和LWE而缩短。LWEP和LWES组之间的MTR差异在前6次复发中是显著的,其中LWEP具有较长的MTR。
方法：
方法：回顾性回顾。
方法：第三系中心。
方法：回顾在2002年至2021年期间接受LWE的iSGS患者。先前没有气道手术的LWE患者被标记为LWE原发性（LWEP），而先前有扩张史的患者被标记为LWE继发性（LWES）。条件性虚弱重复事件模型用于分析每n次复发的中位复发时间（MTR）。次要分析包括通过使用药物治疗和瘢痕的初始术前特征进行分层（Myer-Cotton级，声门和疤痕的最上层之间的距离，DGS;疤痕的长度,DL)。
结果：200名iSGS患者接受了LWE（131LWEP，79LWES）。经历至少1、3、6和12复发的患者比例，分别,为68.0%(n=143)，40.7%(n=85)，20.0%（n=42），5.2%(n=11)。从第1到第12次复发，时间呈指数级缩短（P<0.0001）。虽然地铁在第一次LWE后4.1年，第二次下降到2.8年、1.7年、1.0年和0.7年，3rd,6th,和第12次复发。此外，在前6次复发中，LWEP患者的MTR比LWES患者长（P<0.01）。术中间隔时间与服药依从性无显著关系,DL,DGS,或等级超过第一个（P=0.207，P=0.20，P=0.43，P=0.16）。
结论：iSGS中的无症状间隔随着每次复发和LWE而缩短。LWEP和LWES组之间的MTR差异在前6次复发中是显著的,其中LWEP具有较长的MTR。
方法：
