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Granulation formation following tracheal stenosis stenting: Influence of stent position
Author(s) -
Ko PoJen,
Liu ChienYing,
Wu YiChen,
Chao YinKai,
Hsieh MingJu,
Wu ChingYang,
Wang ChaoJan,
Liu YunHen,
Liu HuiPing
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20615
Subject(s) - stent , medicine , granulation tissue , stenosis , granulation , complication , radiology , surgery , materials science , composite material , wound healing
Abstract Objectives/Hypothesis: To determine whether stent‐to‐vocal fold distance influences morbidity following stent placement for tracheal stenosis. Methods: Fifty‐five stent procedures (46 Montgomery T‐tube [Boston Medical Products, Westborough, MA] and 9 Dumon stents [Novatech, Grasse, France]) were performed in 40 patients enrolled in this study. Results: The most common complication of stenting for tracheal stenosis was granulation (23 procedures, 41.82%). Of 43 procedures where the stent upper edge was located at or below the vocal folds, granulation occurred in 21 procedures (48.84%). Of 12 procedures where the stent edge was located above the vocal fold, granulation occurred in two procedures, or 16.67% (odds ratio = 4.773, P = .0458, χ 2 test). Among patients in whom the stent edge was located at or below the vocal folds, the granulation complication rate was higher in those with a stent‐to‐vocal fold distance of <10 mm. Multivariate analysis revealed that the stent‐to‐vocal fold distance independently predicted granulation formation; an inverse correlation was identified between stent‐to‐vocal fold distance and granulation severity (n = 43, r = −.501, P = .0006; Spearman ranking test). Receiver operating characteristic curve analysis further demonstrated that a stent‐to‐vocal fold distance cutoff value between 9.5 and 11 mm had the best accuracy in predicting granulation formation. Conclusions: A stent‐to‐vocal fold distance of 10 mm was found to be a critical distance for discriminating granulation formation. Optimal stent‐to‐vocal fold distance should routinely be evaluated before stent placement. Laryngoscope, 2009