| Management of postintubation tracheal stenosis: appropriate indications make outcome differences. | |
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MedLine Citation:
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PMID: 20110646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Laryngotracheal stenosis is difficult to treat and its etiologies are multiple; nowadays, the most common ones are postintubation or posttracheostomy stenoses. OBJECTIVE: To provide an algorithm for the management of postintubation laryngotracheal stenoses (PILTS) based on the experience of a tertiary care referral center. METHODS: A retrospective study was conducted on all patients treated for PILTS over a 10-year period. Patients were divided into a surgically and an endoscopically treated group according to predefined criteria. The characteristics of the two groups were analyzed and the outcomes compared. RESULTS: Thirty-three consecutive patients were included in the study: 14 in the surgically treated group and 19 in the endoscopically treated group. Our candidates for airway surgery were healthy patients presenting with complex tracheal stenoses, subglottic involvement or associated tracheomalacia. The endoscopic candidates were chronically ill patients presenting with simple, strictly tracheal stenoses not exceeding 4 cm in length. Stents were placed if the stenosis was associated with tracheomalacia or exceeded 2 cm in total length. In the surgically treated group, 2/14 patients needed more than one procedure versus 8/19 patients in the endoscopically treated group. At the end of the intervention, 50% of the patients were decannulated in the surgically treated group versus 84.2% in the endoscopically treated group (p = 0.03). However, the decannulation rates at 6 months and the symptomatology at rest and on exertion on the last follow-up visit were comparable in the two groups. CONCLUSION: Our experience in the management of PILTS demonstrates that both surgery and endoscopy yield excellent functional outcomes if the treatment strategy is based on clear, predefined objective criteria. |
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Authors:
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Antoine E Melkane; Nayla E Matar; Amine C Haddad; Michel N Nassar; Homère G Almoutran; Ziad Rohayem; Mohammad Daher; Georges Chalouhy; George Dabar |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-01-26 |
Journal Detail:
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Title: Respiration; international review of thoracic diseases Volume: 79 ISSN: 1423-0356 ISO Abbreviation: Respiration Publication Date: 2010 |
Date Detail:
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Created Date: 2010-04-16 Completed Date: 2010-07-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0137356 Medline TA: Respiration Country: Switzerland |
Other Details:
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Languages: eng Pagination: 395-401 Citation Subset: IM |
Copyright Information:
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Copyright 2010 S. Karger AG, Basel. |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anastomosis, Surgical Cricoid Cartilage / surgery Endoscopy* Female Humans Intubation, Intratracheal / adverse effects* Laryngostenosis / etiology, surgery* Lasers, Gas Male Middle Aged Retrospective Studies Stents Trachea / surgery Tracheal Stenosis / etiology, surgery* Tracheostomy / adverse effects |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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