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Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach

OBJECTIVE: The aim was to examine the correlations among the anatomic Cotton-Myer classification, pulmonary function tests (PFTs), and patient-perceived dyspnea or dysphonia in patients with subglottic stenosis and identify measurements accurately reflecting treatment effects. STUDY DESIGN: Prospect...

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Autores principales: Ntouniadakis, Eleftherios, Sundh, Josefin, von Beckerath, Mathias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442627/
https://www.ncbi.nlm.nih.gov/pubmed/34813409
http://dx.doi.org/10.1177/01945998211060817
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author Ntouniadakis, Eleftherios
Sundh, Josefin
von Beckerath, Mathias
author_facet Ntouniadakis, Eleftherios
Sundh, Josefin
von Beckerath, Mathias
author_sort Ntouniadakis, Eleftherios
collection PubMed
description OBJECTIVE: The aim was to examine the correlations among the anatomic Cotton-Myer classification, pulmonary function tests (PFTs), and patient-perceived dyspnea or dysphonia in patients with subglottic stenosis and identify measurements accurately reflecting treatment effects. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. METHOD: Fifty-two adults receiving endoscopic treatment for isolated subglottic stenosis were consecutively included. Correlations were calculated among the preoperative Cotton-Myer scale, PFTs, the Dyspnea Index (DI), and the Voice Handicap Index. Receiver operating characteristic curves were determined for PFT, DI, and Voice Handicap Index pre- and postoperative measurements. RESULTS: The Cotton-Myer classification correlated weakly with peak expiratory flow (r = −0.35, P = .012), expiratory disproportion index (r = 0.32, P = .022), peak inspiratory flow (r = −0.32, P = .022), and total peak flow (r = −0.36, P = .01). The DI showed an excellent area under the curve (0.99, P < .001), and among PFTs, the expiratory disproportion index demonstrated the best area under the curve (0.89, P < .001), followed by total peak flow (0.88, P < .001), peak expiratory flow (0.87, P < .001), and peak inspiratory flow (0.84, P < .001). Patients treated endoscopically with balloon dilatation showed a 53% decrease in expiratory disproportion index (95% CI, 41%-66%; P < .001) and a 37% improvement in peak expiratory flow (95% CI, 31%-43%; P < .001). CONCLUSION: Expiratory disproportion index or peak expiratory flow combined with DI was a feasible measurement for the monitoring of adult subglottic stenosis. The percentage deterioration of peak expiratory flow and increase in expiratory disproportion index correlated significantly with a proportional percentage increase in DI.
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spelling pubmed-94426272022-09-06 Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach Ntouniadakis, Eleftherios Sundh, Josefin von Beckerath, Mathias Otolaryngol Head Neck Surg Laryngology and Neurolaryngology OBJECTIVE: The aim was to examine the correlations among the anatomic Cotton-Myer classification, pulmonary function tests (PFTs), and patient-perceived dyspnea or dysphonia in patients with subglottic stenosis and identify measurements accurately reflecting treatment effects. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. METHOD: Fifty-two adults receiving endoscopic treatment for isolated subglottic stenosis were consecutively included. Correlations were calculated among the preoperative Cotton-Myer scale, PFTs, the Dyspnea Index (DI), and the Voice Handicap Index. Receiver operating characteristic curves were determined for PFT, DI, and Voice Handicap Index pre- and postoperative measurements. RESULTS: The Cotton-Myer classification correlated weakly with peak expiratory flow (r = −0.35, P = .012), expiratory disproportion index (r = 0.32, P = .022), peak inspiratory flow (r = −0.32, P = .022), and total peak flow (r = −0.36, P = .01). The DI showed an excellent area under the curve (0.99, P < .001), and among PFTs, the expiratory disproportion index demonstrated the best area under the curve (0.89, P < .001), followed by total peak flow (0.88, P < .001), peak expiratory flow (0.87, P < .001), and peak inspiratory flow (0.84, P < .001). Patients treated endoscopically with balloon dilatation showed a 53% decrease in expiratory disproportion index (95% CI, 41%-66%; P < .001) and a 37% improvement in peak expiratory flow (95% CI, 31%-43%; P < .001). CONCLUSION: Expiratory disproportion index or peak expiratory flow combined with DI was a feasible measurement for the monitoring of adult subglottic stenosis. The percentage deterioration of peak expiratory flow and increase in expiratory disproportion index correlated significantly with a proportional percentage increase in DI. SAGE Publications 2021-11-23 2022-09 /pmc/articles/PMC9442627/ /pubmed/34813409 http://dx.doi.org/10.1177/01945998211060817 Text en © American Academy of Otolaryngology–Head and Neck Surgery Foundation 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Laryngology and Neurolaryngology
Ntouniadakis, Eleftherios
Sundh, Josefin
von Beckerath, Mathias
Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title_full Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title_fullStr Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title_full_unstemmed Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title_short Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach
title_sort monitoring adult subglottic stenosis with spirometry and dyspnea index: a novel approach
topic Laryngology and Neurolaryngology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442627/
https://www.ncbi.nlm.nih.gov/pubmed/34813409
http://dx.doi.org/10.1177/01945998211060817
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