Abstract
PurposeManagement of benign laryngeal stenosis (BLS) remains challenging even though transoral treatments in selected cases have shown satisfactory results, at least comparable to open-neck approaches, with reduced invasiveness. To date, no overall consensus has been reached on many issues. The aim of this study is to assess the effectiveness of a purely transoral treatment in a cohort of patients affected by BLS.MethodsWe evaluated 40 patients affected by BLS, treated by transoral surgery between 2013 and 2017. The European Laryngological Society classification for laryngotracheal stenosis was applied for the staging. Improvement in airway patency and quality of life was assessed by decannulation rate, Airway-Dyspnea-Voice-Swallowing (ADVS) score, Voice handicap index (VHI)-30, and Eating assessment tool (EAT)-10 questionnaires.ResultsMean age was 61 years and M:F ratio was 1.4:1. Previous laryngeal surgery was the most common cause of stenosis (50%), followed by radiotherapy (20%), idiopathic etiology (12%), granulomatosis with polyangiitis (10%), and prolonged intubation (8%). Transoral treatment entailed an improvement in quality of life with a significant decrease in the VHI score (p < 0.0001) and improvement in Airway (p = 0.008), Dyspnea (p < 0.0001), and Voice (p < 0.0001) scores. No major perioperative complications were observed. The decannulation rate among patients with a tracheostomy in place (N = 16) was 63%.ConclusionsTransoral treatment of selected BLS managed by a team with high-level expertise in surgery and anesthesiology is associated with significant improvement of quality of life, especially with regard to voice and breathing functions.
Highlights
Benign laryngeal stenosis (BLS) usually refers to an abnormal narrowing of the upper airway involving one or more laryngeal sites among the supraglottis, glottis, and subglottis
We considered as primary outcome the postoperative quality of life as tested by ADVS, Voice handicap index (VHI)-30, and Eating assessment tool (EAT)-10 questionnaires
The comparison of the quality of life data gathered preoperatively and at the last follow-up visit showed that the VHI-30 score significantly improved [median V HIpre 88 (IQR 59–95) vs. median VHIpost 10 (IQR 7–17); p < 0.0001]
Summary
Benign laryngeal stenosis (BLS) usually refers to an abnormal narrowing of the upper airway involving one or more laryngeal sites among the supraglottis, glottis, and subglottis. It may be related to various disease processes including iatrogenic causes [post-intubation, post-surgical or. Management of BLS still represents a surgical challenge even though in the last decades transoral approaches performed in referral centers and in selected cases have achieved results comparable to those previously reported using more traditional open-neck procedures, though with less invasiveness [3, 4]. Each BLS case may present unique characteristics and should be assessed according to the patient’s profile, site, severity and etiology of stenosis. As a result, comparing success rates among different treatment modalities becomes quite difficult since they are dependent on the severity of the initial condition, and on the preoperative evaluation and the ensuing choice of treatment [5, 6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
