A research on quality of life in patients who underwent resection for laryngotracheal stenosis

Objective: The aim of this study was to compare the pre- and post-resection clinical features of patients admitted to our clinic with LTS and TS, to investigate the postoperative complications, and to investigate their quality of life in terms of dyspnea, hoarseness and swallowing problems in the long term. Materials and methods: Between January 2016 and May 2023, patients admitted to the Department of Thoracic Surgery of Akdeniz University Hospital with the diagnosis of LTS and TS and treated with surgical resection or dilatation with RB were retrospectively searched from the hospital automation system. Patients whose clinical follow-ups and radiologic images could be accessed and who could be reached and questioned from their registered phones were included in the study. Results: A total of 54 patients were included in the study. The mean age of the patients was 43,72±17,71 years, 40,7% (n=22) were female and 59,3% (n=32) were male. Stenosis due to prolonged intubation developed in 94% (n=51) of the patients. The mean stenotic segment length was 18.65±10.33 mm and the mean intubation time was 16.01±8.75 days. LTR was performed in 26% (n=14), TR in 44% (n=24) and RB in 30% (n=16) of the patients. The rate of postoperative complications was 50% (n=7) in patients who underwent LTR and 8.3% (n=2) in patients who underwent TR (p: 0.004). The postoperative restenosis rate was 42.9% (n=6) in patients undergoing LTR and 4.2% (n=1) in patients undergoing TR (p: 0.003). The mean postoperative VAS score was 2.64±2.98 in patients undergoing LTR, 0.96±1.83 in patients undergoing TR, and 3.63±2.80 in patients undergoing RB (p: 0.005). The mean score of the physical functional subscale of the VRQoL was found to be lower in tracheostomized patients (84.65±18.48) compared to non-tracheostomized patients (p: 0.009). In the physical function, mental health, general health subscales of the 8 subscales of the Quality of Life SF-36 short form, the mean scores of the patients who underwent LTR and TR were better than the patients who underwent RB. Conclusion: Especially because the laryngeal region has a complex structure, hoarseness and swallowing problems may develop after surgical resection and have a negative impact on quality of life. In our study, patients who underwent LTR had lower long-term quality of life in terms of both voice-related quality of life and general quality of life compared to patients who underwent TR. Although surgical treatment is usually successful, we think that patients who develop LTS should be followed up more closely both preoperatively and postoperatively due to the development of more problems related to voice and swallowing. There are few reports evaluating the quality of life of patients who underwent LTR and TR in detail and we aimed to contribute to the literature with our study.