In-depth analysis of pre- and postoperative functional outcome parameters in patients receiving laryngotracheal surgery

Abstract

Background Surgical treatment for airway stenosis necessitates personalized techniques based on the stenosis location and length, leading to favorable surgical outcomes. However, there is limited literature on functional outcomes following laryngotracheal surgery with an adequate number of patients. Material and Methods We conducted a retrospective analysis of patients who underwent laryngotracheal surgery at the Department of Thoracic Surgery, Medical University of Vienna, from January 2017 to June 2021. The study included standardized functional assessments before and after surgery, encompassing spirometry, voice measurements, swallowing evaluation, and subjective patient perception. Results The study comprised 45 patients with an average age of 51.9 ±15.9 years, of whom 89% were female, with idiopathic being the most common etiology (67%). Procedures included standard cricotracheal resection (CTR) in 11%, CTR with dorsal mucosal flap in 49%, CTR with dorsal mucosal flap and lateral cricoplasty in 24%, and single-stage laryngotracheal reconstruction in 16%. There were no in-hospital mortalities or restenosis cases during the mean follow-up period of 20.8±13.2 months. Swallowing function remained intact in all patients. Voice evaluations showed a decrease in fundamental vocal pitch (203 (81-290) Hz vs. 150 (73-364) Hz, p < 0.001) and dynamic voice range (23.5 ±5.8 semitones vs. 17.8 ±6.7 semitones, p < 0.001). However, no differences in voice volume were observed (60.0 ±4.1 dB vs. 60.2 ±4.8 dB, p = 0.788). The overall predicted voice profile changed from R0B0H0 to R1B0H1. Conclusion Laryngotracheal surgery proves effective in fully restoring breathing capacity while preserving vocal function. Even in cases of high-grade and complex airway stenosis necessitating laryngotracheal reconstruction, favorable functional outcomes can be achieved.