ADULT-ACQUIRED LARYNGEAL STENOSIS - A STUDY OF PROGNOSTIC FACTORS

We reviewed cases of adult-acquired laryngeal stenosis treated at the Health Sciences Centre in Winnipeg, Manitoba, over a 15-year period. W e studied the influence of various factors on the final outcome includ ing age, sex, etiology, associated conditions, length and diameter of the stenotic segment, as well as its anatomic site. We found a total o f 32 patients ranging in age from 16 to 73 years. Fifty-five percent w ere caused by intubation and 16% by external trauma. Other causes incl uded inflammatory diseases, irradiation, and burns. The subglottis was involved in 82% of the total number of cases reviewed. We studied the probability of decanulation over time by using the Kaplan-Meier survi val curves. We then identified the independent factors affecting the p robability and time of decanulation by using the Cox Proportional Haza rds model. External trauma was found to have the best outcome when com pared to other etiologies. The anatomic site of stenosis and its lengt h were independent determinants of outcome, while its diameter was not ; involvement-of the glottis in subglottic stenosis led to a significa ntly poorer outcome. We recommend the use of the length and site of st enosis as primary prognostic factors in the assessment of acquired lar yngeal stenosis in the adult population.