Idiopathische progressive subglottische Stenose

Zusammenfassung

Die idiopathische subglottische Stenose verursacht eine Verengung des zentralen Atemwegs am laryngotrachealen Übergang. Die Ätiologie ist unklar. Die Erkrankung betrifft fast ausschließlich Frauen im gebärfähigen Alter, ein Zusammenhang mit dem weiblichen Hormonstoffwechsel ist jedoch nicht zu belegen. Die Vorschläge zur Therapie reichen von rein endoskopischen bis hin zu primär offen-resezierenden Verfahren. Die Wahl der Behandlung dieses heterogenen Krankheitsbildes sollte von der individuellen Befundsituation und der Erfahrung des Therapeuten abhängig gemacht werden. Eine zentrumsgebundene Behandlung diese komplexen und komplikationsträchtigen Krankheitsbildes ist zu empfehlen.

Abstract

Idiopathic subglottic stenosis is causing a narrowing of the central airway at the laryngotracheal junction. Etiology is remaining unclear at large. There is a marked preponderance for women in the fertile age, an association to estrogene or progesterone metabolism remains doubtful. Suggested treatment varies from repeated endoscopic interventions to primary open resection. Therapy selection in this heterogeneous condition should be based on the individual patient situation as well as surgeon’s expertise. This complex entity is prone to complications and should preferably be managed in a referral center.

Schlüsselwörter

laryngotracheale Stenose - cricotracheale Resektion - laryngotracheale Rekonstruktion - Atemwegsstenose

Key words

laryngotracheal stenosis - cricotracheal resection - laryngotracheal reconstruction - airway stenosis

• Literatur

• 1 Nouraei SA, Sandhu GS. Outcome of a multimodality approach to the management of idiopathic subglottic stenosis. The Laryngoscope 2013; 123: 2474-2484
• 2 Brandenburg JH. Idiopathic subglottic stenosis. Transactions – American Academy of Ophthalmology and Otolaryngology American Academy of Ophthalmology and Otolaryngology 1972; 76: 1402-1406
• 3 Valdez TA, Shapshay SM. Idiopathic subglottic stenosis revisited. The Annals of otology, rhinology, and laryngology 2002; 111: 690-695
• 4 Dedo HH, Catten MD. Idiopathic progressive subglottic stenosis: findings and treatment in 52 patients. The Annals of otology, rhinology, and laryngology 2001; 110: 305-311
• 5 Mark EJ, Meng F, Kradin RL et al. Idiopathic tracheal stenosis: a clinicopathologic study of 63 cases and comparison of the pathology with chondromalacia. The American journal of surgical pathology 2008; 32: 1138-1143
• 6 Blumin JH, Johnston N. Evidence of extraesophageal reflux in idiopathic subglottic stenosis. The Laryngoscope 2011; 121: 1266-1273
• 7 Dumoulin E, Stather DR, Gelfand G et al. Idiopathic subglottic stenosis: a familial predisposition. The Annals of thoracic surgery 2013; 95: 1084-1086
• 8 Stone JH. Wegener’s Granulomatosis Etanercept Trial Research G. Limited versus severe Wegener’s granulomatosis: baseline data on patients in the Wegener’s granulomatosis etanercept trial. Arthritis and rheumatism 2003; 48: 2299-2309
• 9 Damrose EJ. On the development of idiopathic subglottic stenosis. Medical hypotheses 2008; 71: 122-125
• 10 Giudice M, Piazza C, Foccoli P et al. Idiopathic subglottic stenosis: management by endoscopic and open-neck surgery in a series of 30 patients. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery 2003; 260: 235-238
• 11 Roediger FC, Orloff LA, Courey MS. Adult subglottic stenosis: management with laser incisions and mitomycin-C. The Laryngoscope 2008; 118: 1542-1546
• 12 Smith ME, Elstad M. Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: are two applications better than one?. The Laryngoscope 2009; 119: 272-283
• 13 Pearson FG, Brito-Filomeno L, Cooper JD. Experience with partial cricoid resection and thyrotracheal anastomosis. The Annals of otology, rhinology, and laryngology 1986; 95: 582-585
• 14 Grillo HC. Management of idiopathic tracheal stenosis. Chest surgery clinics of North America 1996; 6: 811-818
• 15 Pearson FG. Idiopathic laryngotracheal stenosis. The Journal of thoracic and cardiovascular surgery 2004; 127: 10-11
• 16 Ashiku SK, Kuzucu A, Grillo HC, Wright CD, Wain JC, Lo B et al. Idiopathic laryngotracheal stenosis: effective definitive treatment with laryngotracheal resection. The Journal of thoracic and cardiovascular surgery 2004; 127: 99-107
• 17 Sittel C, Blum S et al. Cricotracheal resection in nontracheotomized adults: a prospective case series. The Annals of otology, rhinology, and laryngology 2008; 117: 288-294