1. Functional outcome after single-stage laryngotracheal reconstruction with rib cartilage grafting.
- Author
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Schweiger T, Roesner I, de Faria Soares Rodrigues I, Evermann M, Frick AE, Denk-Linnert DM, Klepetko W, and Hoetzenecker K
- Subjects
- Adult, Austria epidemiology, Deglutition, Female, Humans, Laryngoscopy methods, Male, Recovery of Function, Ribs, Spirometry methods, Treatment Outcome, Voice Quality, Cartilage transplantation, Laryngoplasty adverse effects, Laryngoplasty methods, Laryngostenosis diagnosis, Laryngostenosis epidemiology, Laryngostenosis physiopathology, Laryngostenosis surgery, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Plastic Surgery Procedures adverse effects, Plastic Surgery Procedures methods, Tissue Transplantation methods, Tracheal Stenosis diagnosis, Tracheal Stenosis epidemiology, Tracheal Stenosis physiopathology, Tracheal Stenosis surgery
- Abstract
Objective: Single-stage laryngotracheal reconstruction (SSLTR) provides a definite surgical treatment for patients with complex glotto-subglottic stenosis. To date, the influence of SSLTR on the functional outcome after surgery has not been analyzed., Methods: A retrospective analysis of all patients receiving a SSLTR between November 2012 and October 2019 was performed. Preoperatively and 3 months postoperatively, patients received a full functional evaluation, including spirometry; voice measurements (eg, fundamental frequency; dynamic range, singing voice range, and perceptual voice evaluation using the Roughness-Breathiness-Hoarseness [RBH] score, and fiberoptic endoscopic evaluation of swallowing [FEES])., Results: A total of 15 patients with a mean age of 45 ± 17 years underwent SSTLR. Two (13%) patients were men and 13 (87%) were women. The majority of patients (67%) had undergone previous surgical or endoscopic treatment attempts that had failed. At the 3-month follow-up visit, none of the patients had signs of penetration or aspiration in their swallowing examination. Voice measurements revealed a significantly lower fundamental voice frequency (201.0 Hz vs 155.5 Hz; P = .006), whereas voice range (19.1 semitones vs 14.9 semitones; P = .200) and dynamic range (52.5 dB vs 53.0 dB; P = .777) was hardly affected. The median RBH score changed from R1 B0 H1 to R2 B1 H2. In spirometry, breathing capacity increased significantly (peak expiratory flow, 44% vs 87% [P < .001] and mean expiratory flow at 75% of vital capacity, 48% vs 90% [P < .001]). During a median follow-up of 32.5 months (range, 7-88 months), none of the patients developed re-stenosis., Conclusions: For complex glotto-subglottic stenoses, durable long-term airway patency together with reasonable voice quality and normal deglutition can be achieved by SSLTR., (Copyright © 2020. Published by Elsevier Inc.)
- Published
- 2022
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