Impact of Procedural Variation in Endoscopic Dilation for Idiopathic Subglottic Stenosis.
Impact of Procedural Variation in Endoscopic Dilation for Idiopathic Subglottic Stenosis.
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内镜扩张手术变化对特发性声门下狭窄的影响。
DOI：
10.1002/lary.31393
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Gelbard,Alexander
中科院分区：
文献类型：
--
作者：
Santapuram,Pooja;Tierney,WilliamS;Huang,Li-Ching;Chen,Sheau-Chiann;Berry,LynnD;Francis,DavidO;Gelbard,Alexander
目的全国范围内有少数特发性声门下狭窄（iSGS）患者接受治疗。iSGS内镜扩张（艾德）手术技术的差异已被公认，但尚未正式表征。此外，程序变化和临床outcome.MethodsSecondary分析NoAAC iSGS 1000队列调查的变化，在程序技术和治疗结果与艾德治疗患者在高入组治疗中心（入组>10例患者在PR-02 trial）。各机构的手术细节和复发率存在显著差异。层次聚类分析显示，所有程序变量的机构和集群之间的显着异质性。然而，分析表明，第2组的疾病复发出现短暂延迟，随着纵向随访时间的延长而消失。患者报告的结局和呼气峰流速数据支持第2组中技术变化的潜在受益。然而，与第2组不同的是，常规使用辅助三联药物治疗（质子泵抑制剂（PPI），抗菌药物和类固醇吸入剂）。结论不同中心采用艾德治疗iSGS的结果和程序技术不同。在内镜扩张后对iSGS患者常规处方辅助药物治疗（抗生素、吸入性皮质类固醇和PPI）的中心中观察到复发的短暂延迟，这得到了患者报告数据和呼气峰流速数据的进一步支持。需要前瞻性研究来了解辅助药物治疗对内镜扩张术后复发的影响。证据水平4喉镜，134：3260-3266，2024
ObjectivesA small number of Idiopathic subglottic stenosis (iSGS) patients are treated at institutions across the country. Divergence in operative techniques for endoscopic dilation (ED) of iSGS has been anecdotally recognized but not formally characterized. Additionally, the relationship between procedural variation and clinical outcome has not been studied.MethodsSecondary analysis of the NoAAC iSGS1000cohort investigated variation in procedural techniques and treatment outcomes in patients treated with ED across high‐enrolling treatment centers (enrolled >10 patients in PR‐02 trial).ResultsThirteen NoAAC centers each enrolled >10 patients treated with ED for a total of 281 subjects. There was significant variation in procedural details and rate of recurrence among institutions. Hierarchal cluster analysis revealed significant heterogeneity among institutions and clusters in all procedural variables. However, analysis demonstrated a transient delay in disease recurrence in cluster 2 which disappeared with longer longitudinal follow‐up. Patient‐reported outcome and peak expiratory flow data supported the potential benefit of the technical variation in Cluster 2. Distinct to cluster 2, however, was routine use of adjuvant triple medical therapy (proton pump inhibitor (PPI), antibacterial agent, and steroid inhaler).ConclusionsBoth outcome and procedural technique vary among centers employing ED to treat iSGS. A transient delay in recurrence was observed among centers that routinely prescribed adjuvant medical therapy (antibiotic, inhaled corticosteroid, and PPI) to iSGS patients after endoscopic dilation, which was further supported by patient‐reported data and peak expiratory flow data. Prospective studies are needed to understand the effects of adjuvant medical therapy on recurrence after endoscopic dilation.Level of Evidence4Laryngoscope, 134:3260–3266, 2024
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DOI：
10.1002/lary.25708
发表时间：
2016-06
期刊：
The Laryngoscope
影响因子：
--
作者：
Gelbard A;Donovan DT;Ongkasuwan J;Nouraei SA;Sandhu G;Benninger MS;Bryson PC;Lorenz RR;Tierney WS;Hillel AT;Gadkaree SK;Lott DG;Edell ES;Ekbom DC;Kasperbauer JL;Maldonado F;Schindler JS;Smith ME;Daniero JJ;Garrett CG;Netterville JL;Rickman OB;Sinard RJ;Wootten CT;Francis DO
通讯作者：
Francis DO
影响因子：
2.6
作者：
Blumin, Joel H.;Johnston, Nikki
通讯作者：
Johnston, Nikki
特发性声门下狭窄的比较治疗结果：5 年更新。
DOI：
10.1002/ohn.190
发表时间：
2023
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
--
作者：
W. Tierney;Li;Sheau;Lynne D Berry;Catherine Anderson;Milan R Amin;M. Benninger;J. Blumin;J. Bock;Paul C Bryson;Paul F Castellanos;Matthew S Clary;Seth M. Cohen;Brianna K. Crawley;S. Dailey;James J. Daniero;A. de Alarcón;Donald T. Donovan;E. Edell;D. Ekbom;Daniel S. Fink;Ramon A Franco;C. Gaelyn Garrett;Elizabeth A. Guardiani;A. Hillel;H. Hoffman;N. Hogikyan;R. Howell;Michael M Johns;J. Kasperbauer;S. Khosla;C. Kinnard;Robbi A Kupfer;Alexander J. Langerman;R. Lentz;Robert R Lorenz;D. Lott;Samir S Makani;Fabien Maldonado;L. Matrka;Andrew J. McWhorter;A. Merati;M. Mori;J. Netterville;K. O'Dell;J. Ongkasuwan;G. Postma;Lindsay S Reder;S. Rohde;Brent E. Richardson;O. Rickman;Clark A. Rosen;Matthew L. Rohlfing;Michael J Rutter;Guri S Sandhu;J. Schindler;G. Schneider;R. Shah;Andrew G Sikora;R. Sinard;Marshall E Smith;Libby J. Smith;A. Soliman;Sigríður Sveinsdóttir;D. Veivers;S. Verma;Paul M. Weinberger;P. Weissbrod;C. Wootten;Y. Shyr;David O Francis;A. Gelbard
通讯作者：
A. Gelbard
影响因子：
2.9
作者：
Gelbard A;Shyr Y;Berry L;Hillel AT;Ekbom DC;Edell ES;Kasperbauer JL;Lott DG;Donovan DT;Garrett CG;Sandhu G;Daniero JJ;Netterville JL;Schindler JS;Smith ME;Bryson PC;Lorenz RR;Francis DO
通讯作者：
Francis DO
影响因子：
2.6
作者：
Naunheim, Matthew R.;Paddle, Paul M.;Franco, Ramon A., Jr.
通讯作者：
Franco, Ramon A., Jr.