3.Laryngeal and tracheal stenosis caused by Wegener's granulomatosis.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(9):862-864
Wegener's granulomatosis (WG) is a multisystem disease characterized by necrotizing granulomatous inflammation and vasculitis. WG classically involves the upper airway, lung and kidneys. Otolaryngologic manifestations are often the presenting symptoms in WG, Subglottic stenosis is a less common, but a life-threatening manifestation of WG, This paper studies about the laryngeal and tracheal stenosis diagnosis and surgical treatment of Wegener's granulomatosis in the past 20 years.
Granulomatosis with Polyangiitis
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complications
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physiopathology
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Humans
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Laryngostenosis
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etiology
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physiopathology
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Larynx
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physiopathology
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Tracheal Stenosis
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etiology
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physiopathology
4.Etiology of acute upper respiratory tract obstruction in infants: analysis of 12 cases.
Chinese Journal of Contemporary Pediatrics 2009;11(2):116-119
OBJECTIVETo study the etiology of acute upper respiratory tract obstruction in infants.
METHODSThe medical data of 12 infants with acute upper respiratory tract obstruction were retrospectively reviewed. The patients received the examinations of laryngoscopy and CT scans for larynx and lungs.
RESULTSAll of the 12 infants presented with laryngeal stridor. Eight infants (67%) were diagnosed as congenital simple laryngeal stridor before admission. Based on the clinical features, laboratory examinations, imaging examinations and laryngoscopy, 4 (33%) were definitely diagnosed with thyroglossal ductal cyst, 1(8%) with abscess-emphysema in the posterior wall of pharynx, 1(8%) with cervicallymphangioma, 2 (16%) with subglottic stenosis, and 4 (33%) with acute laryngitis.
CONCLUSIONSAcute upper respiratory tract obstruction is easily misdiagnosed in infants. Thyroglossal duct cyst is a common cause of upper respiratory tract obstruction/laryngeal stridor. It is recommend that laryngoscopy and CT scans for larynx should be performed in infants with laryngeal stridor.
Acute Disease ; Female ; Humans ; Infant ; Laryngoscopy ; Laryngostenosis ; congenital ; diagnosis ; etiology ; Male ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed
5.Outcomes of laryngotracheal reconstruction with anterior and posterior costal cartilage grafts in severe pediatric subglottic stenosis or laryngeal web.
Le Tian TAN ; Yi XIE ; Qi LI ; Chao CHEN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(7):699-704
Objective: To investigate outcomes of laryngotracheal reconstruction (LTR)with anterior and posterior costal cartilage grafts in severe pediatric subglottic stenosis (SGS) or laryngeal web (LW). Methods: A review of patients with severe subglottic stenosis or laryngeal web between January 2020 and January 2022 was performed. Demographic features including gender, age at diagnosis, age at surgery, etiology, airway support, and other comorbidities were collected preoperatively. Patients were evaluated in surgical site, breathing, swallowing, phonation and complications postoperatively.Descriptive analysis was used in this research. Results: Eight patients were included: six with grade Ⅲ SGS following Cotton-Myer grading scale, and two with type Ⅲ LW following Cohen's classification. All patients underwent LTR with anterior and posterior costal cartilage grafts. Five patients underwent single-stage LTR (ssLTR), and three patients underwent double-stage LTR (dsLTR). Seven out of eight patients were able to successfully extubate or decannulate with normal swallowing function; four patients had mild hoarseness, and three had moderate hoarseness. One patient failed in extubation, and underwent tracheotomy. Conclusions: LTR with anterior and posterior costal cartilage grafts is an effective and safe treatment for severe SGS or LW. Careful preoperative assessment of disease severity and overall medical status will help selection between ssLTR and dsLTR, thereby maximizing patient outcomes for both modalities.
Child
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Humans
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Constriction, Pathologic/complications*
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Costal Cartilage
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Hoarseness
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Laryngeal Diseases/complications*
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Laryngostenosis/etiology*
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Retrospective Studies
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Treatment Outcome
6.Fiberoptic bronchoscope guided intubation low-pressure cuff on tracheal intubation expansion for prevention traumatic stenosis.
Yang TAN ; Yan-mei LIU ; Li-zhen YAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2010;45(10):864-865
Adult
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Bronchoscopy
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Female
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Humans
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Intubation, Intratracheal
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adverse effects
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methods
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Laryngostenosis
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etiology
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prevention & control
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Larynx
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injuries
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Male
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Wounds and Injuries
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surgery
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Young Adult
7.Prevention of laryngeal webs through endoscopic keel placement for bilateral vocal cord lesions.
Jian CHEN ; Yilai SHU ; Matthew R NAUNHEIM ; Min CHEN ; Lei CHENG ; Haitao WU
Frontiers of Medicine 2018;12(3):301-306
Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group (18.6% versus 54.5%, P < 0.05). Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups (P < 0.0001 and P < 0.001, respectively). A pseudomembrane covering the vocal cords was detected in 16.3% (7 of 43) cases after keel removal. A total of 100% (7 of 7) of these cases and 2.8% (1 of 36) of the other cases formed laryngeal webs (P < 0.0001). Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.
Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Laryngoscopy
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Laryngostenosis
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diagnosis
;
etiology
;
surgery
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Larynx
;
abnormalities
;
surgery
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Male
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Middle Aged
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Retrospective Studies
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Silicone Elastomers
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Young Adult
8.Analysis of traumatic laryngotracheal stenosis in 63 cases.
Liang-fa LIU ; Wen-ming WU ; Jia-ling WANG ; Bo FENG ; Hui ZHAO ; De-liang HUANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2009;44(5):389-394
OBJECTIVETo explore the surgical treatment and the principle of selecting approaches in traumatic laryngotracheal stenosis.
METHODSSixty three cases of traumatic laryngotracheal stenosis treated in the Department of Otolaryngology, Head and Neck Surgery, Chinese People's Liberation Arauy General Hospital from 1993-2006 were reviewed. The surgical treatment and the effects were analyzed.
RESULTSAmong the 63 cases, 99 operations were accomplished in total, excluding tracheotomy and the closure operation for the fistula. Forty patients had experienced one operation (63.5%), 15 cases (23.8%) had 2 operations, 5 cases had 3 operations, 2 cases had 4 operations, and one case had 6 operations. Fifteen initially estimated as laryngotracheal stenosis with intact framework had supporting laryngoscopic surgery, 11 cases decannulated successfully after single operation. Primary laryngotracheal split and plasticity with T tube implantation were accomplished in 36 cases, with 20 cases decannulated. Among 10 cases experienced laryngotracheal split, skin graft in laryngotracheal cavity with T tube implantation, 7 decannulated. Among 6 cases of laryngotracheal split, pedicled hyoid flap transfer for reconstruction of the laryngotracheal framework defect, 4 cases decannulated. Tracheal and cricotracheal resection and end-end anastomosis were performed in 9 cases, 7 cases decannulated after single procedure. Two cases of subglottic stenosis with tracheoesophageal fistula were repaired with laryngotracheal plasticity in single procedure successfully. Fifty seven patients were decannulated after different procedures with variable hoarseness, within 6 months to 5 years follow-up. Six cases failed in decannulation. The decannulation rate was 90.5%.
CONCLUSIONSTraumatic laryngotracheal stenosis is a complex problem that usually needs a longer time for reconstruction and a different ways of approaches. It is necessary to evaluate the laryngotracheal framework defect, the degree and extension of stenosis systematically before operation for surgical planning.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Laryngoscopy ; Laryngostenosis ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies ; Tracheal Stenosis ; diagnosis ; etiology ; surgery ; Tracheoesophageal Fistula ; diagnosis ; etiology ; surgery ; Treatment Outcome ; Young Adult
9.Analysis of relevant factors causing laryngeal stenosis after partial laryngectomy.
Xuan WU ; Zhen-zhong SU ; Ai-yun JIANG ; Ai-hua LIN ; Li-ping CHAI ; Wei-ping WEN ; Wen-bin LEI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2005;40(12):929-932
OBJECTIVETo investigate the clinical relevant factors causing laryngeal stenosis after partial laryngectomy.
METHODSA retrospective study was carried out to review the history clinical data from 138 patients of partial laryngectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 1994 to October 2004. The clinical relevant factors causing laryngeal stenosis were included as follows: age, sex, TNM stage, tumor site, extension of thyroid cartilage defect, extension of larynx parenchyma defect, reconstruction method, laryngeal dilator, duration of using antibiotics, postoperative radiotherapy, lung infection, gastroesophageal reflux, diabetes. Multivariate stepwise logistic regression model was used for the analysis.
RESULTSOf 138 cases after partial laryngectomy, stenosis developed in 25 cases. The occurrence rate was 18.1%. In multivariate analysis, it was confirmed that the following factors correlated to laryngeal stenosis, i. e, extension of thyroid cartilage defect (chi2 = 4.323, P = 0.038), postoperative radiotherapy (chi2 = 6.002, P = 0.014), lung infection (chi2 = 4.220, P = 0.040), and gastroesophageal reflux (chi2 = 5.614, P = 0.018).
CONCLUSIONSThe clinical relevant factors causing laryngeal stenosis after partial laryngectomy were multiple. Statistical analysis showed that extension of thyroid cartilage defect, postoperative radiotherapy, lung infection and gastroesophageal reflux were the risk factors which may cause laryngeal stenosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; adverse effects ; Laryngostenosis ; etiology ; pathology ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; Retrospective Studies ; Risk Factors