Characterizing radiation-related laryngotracheal stenosis

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2025-04-22 DOI:10.1016/j.amjoto.2025.104643

Natalia Queenan , Jay Trivedi , Dylan Bertoni , Sana H. Siddiqui , Austin Yap , Kathleen M. Tibbetts

{"title":"Characterizing radiation-related laryngotracheal stenosis","authors":"Natalia Queenan , Jay Trivedi , Dylan Bertoni , Sana H. Siddiqui , Austin Yap , Kathleen M. Tibbetts","doi":"10.1016/j.amjoto.2025.104643","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Radiation-related laryngotracheal stenosis (RLTS) develops due to fibrosis of the airway after radiotherapy. We aim to characterize the presentation, management, and outcomes of patients with RLTS and compare these to patients with iatrogenic laryngotracheal stenosis (ILTS).</div></div><div><h3>Methods</h3><div>In a single-center retrospective cohort study, patients diagnosed with RLTS between 2017 and 2022 were identified. Demographic data, risk factors, cancer history and treatment, presentation of stenosis, primary stenosis intervention, and outcomes were extracted. Patients were compared to a cohort of patients with ILTS and no history of radiation therapy. Data were analyzed using Fisher's Exact Tests and paired <em>t</em>-tests.</div></div><div><h3>Results</h3><div>Seven patients with head and neck malignancies (six laryngeal, one thyroid) who developed RLTS after radiation therapy were included. One patient had supraglottic stenosis, three glottic, five subglottic, and two tracheal. Mean time to diagnosis of RLTS from initiation of radiation was 14.8 months (range: 2–46 months). Five patients were treated with laser ablation of stenosis. The patients with RLTS were compared to a cohort of 105 patients with ILTS. Patients with RLTS were less likely to have obesity (Odds Ratio (OR) = 0.06; 95 % Confidence Interval (CI) = 0.003–0.99) and more likely to have coronary vascular disease (OR = 5.5; 95 % CI = 1.04–29.6). No significant differences in interventions or outcomes were found.</div></div><div><h3>Conclusions</h3><div>Risk factors for RLTS and ILTS differ, but management strategies and treatment outcomes are comparable.</div><div>Level of evidence: IV</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104643"},"PeriodicalIF":1.8000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0196070925000468","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Radiation-related laryngotracheal stenosis (RLTS) develops due to fibrosis of the airway after radiotherapy. We aim to characterize the presentation, management, and outcomes of patients with RLTS and compare these to patients with iatrogenic laryngotracheal stenosis (ILTS).

Methods

In a single-center retrospective cohort study, patients diagnosed with RLTS between 2017 and 2022 were identified. Demographic data, risk factors, cancer history and treatment, presentation of stenosis, primary stenosis intervention, and outcomes were extracted. Patients were compared to a cohort of patients with ILTS and no history of radiation therapy. Data were analyzed using Fisher's Exact Tests and paired t-tests.

Results

Seven patients with head and neck malignancies (six laryngeal, one thyroid) who developed RLTS after radiation therapy were included. One patient had supraglottic stenosis, three glottic, five subglottic, and two tracheal. Mean time to diagnosis of RLTS from initiation of radiation was 14.8 months (range: 2–46 months). Five patients were treated with laser ablation of stenosis. The patients with RLTS were compared to a cohort of 105 patients with ILTS. Patients with RLTS were less likely to have obesity (Odds Ratio (OR) = 0.06; 95 % Confidence Interval (CI) = 0.003–0.99) and more likely to have coronary vascular disease (OR = 5.5; 95 % CI = 1.04–29.6). No significant differences in interventions or outcomes were found.

Conclusions

Risk factors for RLTS and ILTS differ, but management strategies and treatment outcomes are comparable.

Level of evidence: IV

查看原文本刊更多论文

放射相关喉气管狭窄的特征

放射相关性喉气管狭窄（RLTS）是由于放射治疗后气道纤维化而发生的。我们的目的是描述RLTS患者的表现、治疗和结果，并将其与医源性喉气管狭窄（ILTS）患者进行比较。方法在一项单中心回顾性队列研究中，确定了2017年至2022年诊断为RLTS的患者。统计资料、危险因素、癌症病史和治疗、狭窄的表现、原发性狭窄干预和结果被提取出来。将患者与一组没有放射治疗史的ILTS患者进行比较。数据分析采用Fisher精确检验和配对t检验。结果7例头颈部恶性肿瘤（喉癌6例，甲状腺癌1例）放疗后发生RLTS。1例声门上狭窄，3例声门狭窄，5例声门下狭窄，2例气管狭窄。从放疗开始到诊断RLTS的平均时间为14.8个月（范围：2-46个月）。5例患者行狭窄激光消融治疗。将RLTS患者与一组105例ILTS患者进行比较。RLTS患者发生肥胖的可能性较低(优势比(OR) = 0.06；95%可信区间(CI) = 0.003-0.99)，更容易患冠状动脉疾病(OR = 5.5；95% ci = 1.04-29.6)。在干预措施或结果方面没有发现显著差异。结论RLTS和ILTS的危险因素不同，但管理策略和治疗结果具有可比性。证据等级：四级

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

期刊介绍： Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.