Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review
Purpose: To identify different endoscopic techniques for treatment of idiopathic subglottic stenosis (iSGS) and evaluate treatment results.Methods: Embase and Cochrane Library were searched for publications on endoscopically treated iSGS. Identified interventions included procedures with cold knife,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fsurg.2019.00075/full |
| _version_ | 1811196012184731648 |
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| author | Emilie Lavrysen Greet Hens Pierre Delaere Jeroen Meulemans |
| author_facet | Emilie Lavrysen Greet Hens Pierre Delaere Jeroen Meulemans |
| author_sort | Emilie Lavrysen |
| collection | DOAJ |
| description | Purpose: To identify different endoscopic techniques for treatment of idiopathic subglottic stenosis (iSGS) and evaluate treatment results.Methods: Embase and Cochrane Library were searched for publications on endoscopically treated iSGS. Identified interventions included procedures with cold knife, dilation (rigid or balloon), or laser (CO2 or Nd:YAG), used in several combinations and supplemented with mitomycin C and/or corticosteroids. Primary endpoint was time interval between successive endoscopic procedures. Secondary endpoints were stenosis recurrence rate, total number of interventions per patient during follow-up, tracheotomy rate, and rate of open surgery.Results: Eighty-six abstracts were reviewed and 15 series were included in the analysis. Mean sample size was 57 subjects (range 10–384, σ 90.84) and mean age was 47 years (range 36–54, σ 4.45). Time interval ranged from 2 to 21 months [weighted mean (WM): 12]. Rate of stenosis recurrence ranged from 40 to 100% (WM: 68%). Mean amount of interventions per patient varied between 1.8 and 8.3 (WM: 3.7). Tracheotomy rate varied between 0 and 26% (WM: 7%) and rate of open surgery varied between 0 and 27% (WM: 10%). Single modality CO2 lasering showed highest rate of recurrence, highest amount of interventions, and shortest time interval. Combined techniques generated overall better outcomes.Conclusions: A multitude of endoscopic techniques are being used for treating iSGS, all with a considerable recurrence rate. In this review, no superior modality could be identified. Consequently, endoscopic management could be considered a valuable primary treatment option for iSGS, but open surgery still plays an important role. |
| first_indexed | 2024-04-12T00:51:57Z |
| format | Article |
| id | doaj.art-e9b1d16b07244c74b9959c0adcf94072 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T00:51:57Z |
| publishDate | 2020-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-e9b1d16b07244c74b9959c0adcf940722022-12-22T03:54:43ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2020-01-01610.3389/fsurg.2019.00075510019Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic ReviewEmilie LavrysenGreet HensPierre DelaereJeroen MeulemansPurpose: To identify different endoscopic techniques for treatment of idiopathic subglottic stenosis (iSGS) and evaluate treatment results.Methods: Embase and Cochrane Library were searched for publications on endoscopically treated iSGS. Identified interventions included procedures with cold knife, dilation (rigid or balloon), or laser (CO2 or Nd:YAG), used in several combinations and supplemented with mitomycin C and/or corticosteroids. Primary endpoint was time interval between successive endoscopic procedures. Secondary endpoints were stenosis recurrence rate, total number of interventions per patient during follow-up, tracheotomy rate, and rate of open surgery.Results: Eighty-six abstracts were reviewed and 15 series were included in the analysis. Mean sample size was 57 subjects (range 10–384, σ 90.84) and mean age was 47 years (range 36–54, σ 4.45). Time interval ranged from 2 to 21 months [weighted mean (WM): 12]. Rate of stenosis recurrence ranged from 40 to 100% (WM: 68%). Mean amount of interventions per patient varied between 1.8 and 8.3 (WM: 3.7). Tracheotomy rate varied between 0 and 26% (WM: 7%) and rate of open surgery varied between 0 and 27% (WM: 10%). Single modality CO2 lasering showed highest rate of recurrence, highest amount of interventions, and shortest time interval. Combined techniques generated overall better outcomes.Conclusions: A multitude of endoscopic techniques are being used for treating iSGS, all with a considerable recurrence rate. In this review, no superior modality could be identified. Consequently, endoscopic management could be considered a valuable primary treatment option for iSGS, but open surgery still plays an important role.https://www.frontiersin.org/article/10.3389/fsurg.2019.00075/fullballoon dilationcarbon dioxide laseridiopathic subglottic stenosislaryngotracheal stenosismitomycin CNd:YAG laser |
| spellingShingle | Emilie Lavrysen Greet Hens Pierre Delaere Jeroen Meulemans Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review Frontiers in Surgery balloon dilation carbon dioxide laser idiopathic subglottic stenosis laryngotracheal stenosis mitomycin C Nd:YAG laser |
| title | Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review |
| title_full | Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review |
| title_fullStr | Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review |
| title_full_unstemmed | Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review |
| title_short | Endoscopic Treatment of Idiopathic Subglottic Stenosis: A Systematic Review |
| title_sort | endoscopic treatment of idiopathic subglottic stenosis a systematic review |
| topic | balloon dilation carbon dioxide laser idiopathic subglottic stenosis laryngotracheal stenosis mitomycin C Nd:YAG laser |
| url | https://www.frontiersin.org/article/10.3389/fsurg.2019.00075/full |
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