Long-Term Stenting in the Treatment of Subglottic Stenosis

Goode, Richard L.; Shinn, John B.

doi:10.1177/000348947708600613

Cited by 44 publications

(10 citation statements)

References 5 publications

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“…Treatments have been investigated in animal studies and clinical practice for over 30 years. These include systemic antibiotics and systemic steroids,5–7 local injection of steroids,8–12 and stents 13–16. In recent years, the most attention has been turned to mitomycin‐C (MMC) 17.…”

Section: Introductionmentioning

confidence: 99%

Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: Are two applications better than one?

2009

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This prospective randomized double-blind placebo-controlled trial suggests that, in the endoscopic management of laryngotracheal stenosis, two applications of MMC given 3-4 weeks apart after airway radial incision and dilation reduces the restenosis rate for 2 to 3 years after treatment when compared to a single application. However, restenosis and delayed symptom recurrence continues so that at 5 years the relapse rates are the same. Thus, MMC may postpone, but does not prevent, the recurrence of symptomatic stenosis in the majority of patients.

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Section: Introductionmentioning

confidence: 99%

Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: Are two applications better than one?

2009

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“…Hence the endotracheal tube was used, which proved to be a very reliable stent for the supra glottic stenosis repair surgery. Some authors feel that keeping stents for greater than 6 weeks does not imporve the end result (Healy, 1982) whereas others recommend periods upto 11 months with good results (Goode, 1977). All our patients were put on post-operative antibiotics and steroids for variable iamounts of time.…”

Section: Discussionmentioning

confidence: 88%

Surgical management of Supraglottic stenosis

Kacker

Deka

Chatterjee

1993

Indian J Otolaryngol Head Neck Surg

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“…Unfortunately, laryngeal stents can also act as foreign bodies in the reconstructed airway and induce mucosal injuries, ulcerations, granulation tissue formation and subsequent restenosis if their anatomical conformity to the inner laryngeal contours is not perfect or if their consistency is too hard. Ideally, a dedicated laryngeal stent should conform to airway contours, exert <30 mmHg of mucosal pressure, resist compressive forces, maintain airway anatomy, move with the larynx during respiration and deglutition and be biocompatible [6]. …”

Section: Introductionmentioning

confidence: 99%

Airway stenting with the LT-Mold™ for severe glotto-subglottic stenosis or intractable aspiration: experience in 65 cases

Alshammari

Monnier

2012

Eur Arch Otorhinolaryngol

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The purpose of this study was to assess the safety and efficacy of stenting in upper airway reconstructions for benign laryngotracheal stenosis (LTS) with a newly designed prosthesis, the LT-Mold™. The LT-Mold and its proper use during open surgery and endoscopy are described, and the experience gathered from a prospectively collected database on 65 patients treated for complex LTS or severe aspiration is reported. This series is compared to the results of other stenting methods. All patients were available for evaluation. In all but one case, the prosthesis was removed at the end of the study. The new prosthesis did not induce any stent-related trauma to the supraglottis, glottis and subglottis. Before adding a distal round-shaped silicone cap to the LT-Mold, granulation tissue was usually seen at the stent-mucosal interface at the tracheostoma level. In 14 cases, there has been a spontaneous extrusion of the prosthesis through the mouth; this problem was solved by fixing the prosthesis through the reinforced portion of the prosthesis at the cap level and by adding one fixation stitch in the supraglottis. We have to document the loss of the silicone cap in three cases. This problem was resolved by designing a new prototype with an integrated cap, glued with a slow hardening silicone glue. Fifty-four (83 %) of 65 patients were decannulated after a mean duration of stenting of 3 months (range 1–12 months). The mean follow-up after decannulation was 23 months (range 1 month to 10 years). The experience gathered with the LT-Mold shows that long-term stenting for complex LTS is safely achieved when the prosthesis is used with its distal integrated silicone cap. The softness and smoothness of the prosthesis with a round-shaped configuration of both extremities help avoid ulceration and granulation tissue formation in the reconstructed airway. Adequate fixation is mandatory to avoid extrusion.

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Long-Term Stenting in the Treatment of Subglottic Stenosis

Abstract: Long-term stenting (3 to 12 months) with silicone rubber stents was found successful in 12 of 14 cases (86%) with severe subglottic stenosis. A new silicone rubber stent is described that is suitable for long-term stenting in infants or adults.

Cited by 44 publications

References 5 publications

Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: Are two applications better than one?

Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: Are two applications better than one?

Surgical management of Supraglottic stenosis

Airway stenting with the LT-Mold™ for severe glotto-subglottic stenosis or intractable aspiration: experience in 65 cases

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