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RACS ASC 2024

Surgical management of adult subglottic and tracheal stenosis: A 10-year institutional review.

Verbal Presentation

Verbal Presentation

4:45 pm

07 May 2024

Bealey 4

RESEARCH PAPERS

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Institution: St Vincent's Hospital Melbourne - Victoria, Australia

Purpose: To compare the patient characteristics, aetiology and surgical management of patients with subglottic, tracheal or mixed airway stenosis. Methodology: A 10-year retrospective chart review of airway stenosis patients between 2012 and 2022 at St Vincent’s Hospital Melbourne was undertaken. Patients who underwent airway surgery were identified, and demographic, disease and perioperative management details were extracted. Comparisons were made between the subglottic stenosis (SGS), tracheal stenosis (TS) and mixed subglottic/tracheal stenosis (SGTS) groups. Results: There were 80 SGS procedures in 30 patients. 63% of patients were idiopathic. Diagnostic or serial endoscopy was performed in all SGS patients, with the most common intervention being balloon dilatation (38%). 33 TS patients had 84 procedures. 27% of these patients were idiopathic, and 24% each were iatrogenic and neoplastic. Most TS procedures involved endoscopy, dilatation and laser (29%), or endoscopy and dilatation (23%). There was also a trend towards more open procedures (tracheostomy and tracheoplasty). In the 19 SGTS patients, most commonly idiopathic and iatrogenic (53% and 21% of patients, respectively), 118 procedures were performed. The autoimmune disease subgroup (11% of patients) comprised 61% of procedures. Endoscopy and dilatation was most common (42%), followed by endoscopy, dilatation and steroid injection (36%). Conclusion: Idiopathic disease was the predominant aetiology in all three subgroups of stenosis, and most cases were treated with endoscopy and dilatation, with or without steroid injections or laser. SGS and mixed SGTS were more common in women. TS patients were more likely to undergo open procedures.

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Dr Adham Elsiwy - , Dr Jonathan Emmerson - , Dr May Tsai - , Dr Eric Levi -