BACKGROUND: Treatment for adult subglottic stenosis is technically demanding and no therapeutic algorithm exists. We performed the present meta-analysis of treatment for this condition in an attempt to compare efficacy on the basis of type of procedure. METHODS: We identified 24 eligible retrospective studies reporting the therapeutic results for inclusion criteria. Meta-analysis was performed by combining the results of the reported success rates; success is defined as a condition requiring no further treatment. The relative risk was used as a summary statistic. RESULTS: Pooled success rates of laryngotracheal resection and anastomosis (12 articles) and laryngoplasty with or without grafting (7 articles) were 95% and 76%, respectively, using a random-effects model. Success rates of endoscopic dilatation and laser resection (6 articles) varied between 40% and 82%. Meta-regression analysis showed a significant difference in the success rates between laryngotracheal reconstruction and laryngoplasty and between laryngotracheal reconstruction and an endoscopic procedure. When the indication for endoscopic management was a lesion size less than 1 cm, the results were significantly better. CONCLUSIONS: The success rate of laryngotracheal reconstruction is significantly higher than that of laryngoplasty or endoscopic intervention; however, endoscopic intervention is worth trying for lesions smaller than 1 cm without framework destruction.
BACKGROUND: Treatment for adult subglottic stenosis is technically demanding and no therapeutic algorithm exists. We performed the present meta-analysis of treatment for this condition in an attempt to compare efficacy on the basis of type of procedure. METHODS: We identified 24 eligible retrospective studies reporting the therapeutic results for inclusion criteria. Meta-analysis was performed by combining the results of the reported success rates; success is defined as a condition requiring no further treatment. The relative risk was used as a summary statistic. RESULTS: Pooled success rates of laryngotracheal resection and anastomosis (12 articles) and laryngoplasty with or without grafting (7 articles) were 95% and 76%, respectively, using a random-effects model. Success rates of endoscopic dilatation and laser resection (6 articles) varied between 40% and 82%. Meta-regression analysis showed a significant difference in the success rates between laryngotracheal reconstruction and laryngoplasty and between laryngotracheal reconstruction and an endoscopic procedure. When the indication for endoscopic management was a lesion size less than 1 cm, the results were significantly better. CONCLUSIONS: The success rate of laryngotracheal reconstruction is significantly higher than that of laryngoplasty or endoscopic intervention; however, endoscopic intervention is worth trying for lesions smaller than 1 cm without framework destruction.
Authors: Sabina Dang; Justin R Shinn; Benjamin R Campbell; Gaelyn Garrett; Christopher Wootten; Alexander Gelbard Journal: Laryngoscope Date: 2019-07-29 Impact factor: 3.325
Authors: Linda X Yin; William V Padula; Shekhar Gadkaree; Kevin Motz; Sabrina Rahman; Zachary Predmore; Alexander Gelbard; Alexander T Hillel Journal: Otolaryngol Head Neck Surg Date: 2018-11-27 Impact factor: 3.497
Authors: Pelin Kocdor; Eric R Siegel; James Y Suen; Gresham Richter; Ozlem E Tulunay-Ugur Journal: Eur Arch Otorhinolaryngol Date: 2015-09-03 Impact factor: 2.503
Authors: Simone T Timman; Christiana Schoemaker; Wilson W L Li; Henri A M Marres; Jimmie Honings; Wim J Morshuis; Erik H F M van der Heijden; Ad F T M Verhagen Journal: Ann Cardiothorac Surg Date: 2018-03