Zane D Kaiser, Yasine Mirmozaffari, Robert A Buckmire, Rupali N Shah
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引用次数: 0
Abstract
Objectives: To determine time to maximal airway improvement in subglottic stenosis (SGS) patients after endoscopic surgery, measured by peak flow meter (PFM). Secondarily, to evaluate whether patient demographics, intraoperative treatments, or adjunctive medications influenced time to or change in maximal recovery.
Methods: We performed a retrospective and prospective analysis of 42 SGS patients undergoing endoscopic surgery at the UNC Voice Center. PFM measurements were taken once preoperatively and weekly for 6 months postoperatively. Patient demographics, comorbidities, diagnostic etiology, intraoperative treatments (steroid injection, Mitomycin C, none), and postoperative medications (oral steroids, antibiotics, none) were recorded. Primary outcomes included time to maximal postoperative PFM (tmPFM) and percent change in PFM (%∆PFM). Mann-Whitney U, Kruskal-Wallis, and linear regression were used to assess the influence of stratifying factors on outcomes.
Results: Average %∆PFM and increase in PFM following surgery were 98% (SD 69) and 164 L/min (SD 67). Mean tmPFM was 32 days (SD 17). Older age significantly impacted %∆PFM (coefficient of 1.713, p = 0.03) but not tmPFM. No statistically significant differences were found for %∆PFM or tmPFM vs. diagnostic etiology, comorbidities, BMI, intraoperative treatment, and postoperative medications, but the analysis was underpowered for subgroup analysis.
Conclusion: Time to maximal airway caliber following endoscopic airway surgery is not immediate; most patients reach maximal airflow between 18 and 39 days postoperatively, with an average 98% increase in PFM. Further study is needed to determine the impact of intraoperative medications (steroid injection and mitomycin C) and postoperative medications (steroids or antibiotics) on postoperative healing.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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