The Laryngoscope · 2025
Outcomes in Awake Laser Laryngeal Stenosis Surgery (ALLSS): A 5-Year Retrospective Review.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
D'Oto Alexandra D, Marshall Camryn R, Ma Yue, Young VyVy N, Rosen Clark A
Аннотация
OBJECTIVES: In patients with significant upper airway stenosis, airway compromise can occur associated with general anesthesia (GA). A previous study demonstrated the feasibility of awake laser laryngeal stenosis surgery (ALLSS) in the operating room (OR) in five patients. This study sought to determine patient outcomes of ALLSS.
METHODS: Retrospective chart review identified 32 surgical cases (11 bilateral, 21 unilateral) among 16 patients over a 5-year period. At least unilateral transverse cordotomy, or CO2 laser excision of glottic and/or supraglottic stenosis, was performed. Patient demographics, complications, outcomes, and pre- and post-procedure voice handicap index-10 (VHI-10), eating assessment tool-10 (EAT-10) and dyspnea index (DI) were analyzed.
RESULTS: Of 16 patients (mean age = 65.6, 68.8% male), postoperative DI was significantly lower than preoperative DI (p = 0.001) with no significant difference in pre- and postoperative VHI-10 (p = 0.132) or EAT-10 (p = 0.316). Two surgical events required general anesthesia conversion. Two patients were tracheostomy dependent preoperatively with one successfully decannulated postoperatively. Three of the remaining 14 patients (21%) ultimately required tracheostomy due to aspiration pneumonia (n = 1) and fixed airway obstruction (n = 2). Of 32 surgeries, three major (airway edema requiring hospitalization, intubation due to respiratory failure, urgent tracheostomy) and three minor (three post-operative granulomas, two of which required surgical intervention) complications occurred. No bleeding difficulties were encountered associated with ALLSS.
CONCLUSIONS: ALLSS can provide meaningful improvement for the treatment of glottic/supraglottic stenosis and may provide an effective alternative to stenosis surgery done under general anesthesia. At present, ALLSS should be performed in the OR with an experienced anesthesia team.
METHODS: Retrospective chart review identified 32 surgical cases (11 bilateral, 21 unilateral) among 16 patients over a 5-year period. At least unilateral transverse cordotomy, or CO2 laser excision of glottic and/or supraglottic stenosis, was performed. Patient demographics, complications, outcomes, and pre- and post-procedure voice handicap index-10 (VHI-10), eating assessment tool-10 (EAT-10) and dyspnea index (DI) were analyzed.
RESULTS: Of 16 patients (mean age = 65.6, 68.8% male), postoperative DI was significantly lower than preoperative DI (p = 0.001) with no significant difference in pre- and postoperative VHI-10 (p = 0.132) or EAT-10 (p = 0.316). Two surgical events required general anesthesia conversion. Two patients were tracheostomy dependent preoperatively with one successfully decannulated postoperatively. Three of the remaining 14 patients (21%) ultimately required tracheostomy due to aspiration pneumonia (n = 1) and fixed airway obstruction (n = 2). Of 32 surgeries, three major (airway edema requiring hospitalization, intubation due to respiratory failure, urgent tracheostomy) and three minor (three post-operative granulomas, two of which required surgical intervention) complications occurred. No bleeding difficulties were encountered associated with ALLSS.
CONCLUSIONS: ALLSS can provide meaningful improvement for the treatment of glottic/supraglottic stenosis and may provide an effective alternative to stenosis surgery done under general anesthesia. At present, ALLSS should be performed in the OR with an experienced anesthesia team.