TY - JOUR
T1 - Long-Term Laryngotracheal Complications After Inhalation Injury
T2 - A Scoping Review
AU - Zhen, Emily
AU - Misso, Dylan
AU - Rea, Suzanne
AU - Vijayasekaran, Shyan
AU - Fear, Mark
AU - Wood, Fiona
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2023/3/2
Y1 - 2023/3/2
N2 - Long-term laryngotracheal complications (LTLC) after inhalation injury (II) are an under-recognized condition in patients with burns. The purpose of this study was to systematically review all available evidence on LTLC after II and identify gaps in knowledge to guide the direction of future research. A scoping review was performed to synthesize all available evidence on LTLC after II, as guided by the question, "What are the LTLC after II, in patients with or without a history of translaryngeal intubation and/or tracheostomy?". MEDLINE, Web of Science, Ovid Embase, Cochrane Library, and Google Scholar were searched for publications on this topic. Of the 3567 citations screened, a total of 153 full-text articles were assessed for eligibility and 49 were included in the scoping review. The overall level of evidence was low, with case reports constituting 46.7% of all included human studies. The lesions were most frequently in the trachea (36.9%), followed by the glottis (34.7%) and subglottis (19.0%). LTLC occur in 4.8 to 6.5% of patients after II and these complications are under-recognized in burns patients. The risk factors for LTLC include high-grade II, elevated initial inflammatory responses, prolonged translaryngeal intubation, and a history of tracheostomy. The goal of management is to restore airway patency, preserve voice quality, and restore normal diet and swallow function. There is limited high-level evidence on LTLC, particularly with regards to long-term functional morbidity in voice and swallow. Large, prospective studies are required to address this gap in knowledge.
AB - Long-term laryngotracheal complications (LTLC) after inhalation injury (II) are an under-recognized condition in patients with burns. The purpose of this study was to systematically review all available evidence on LTLC after II and identify gaps in knowledge to guide the direction of future research. A scoping review was performed to synthesize all available evidence on LTLC after II, as guided by the question, "What are the LTLC after II, in patients with or without a history of translaryngeal intubation and/or tracheostomy?". MEDLINE, Web of Science, Ovid Embase, Cochrane Library, and Google Scholar were searched for publications on this topic. Of the 3567 citations screened, a total of 153 full-text articles were assessed for eligibility and 49 were included in the scoping review. The overall level of evidence was low, with case reports constituting 46.7% of all included human studies. The lesions were most frequently in the trachea (36.9%), followed by the glottis (34.7%) and subglottis (19.0%). LTLC occur in 4.8 to 6.5% of patients after II and these complications are under-recognized in burns patients. The risk factors for LTLC include high-grade II, elevated initial inflammatory responses, prolonged translaryngeal intubation, and a history of tracheostomy. The goal of management is to restore airway patency, preserve voice quality, and restore normal diet and swallow function. There is limited high-level evidence on LTLC, particularly with regards to long-term functional morbidity in voice and swallow. Large, prospective studies are required to address this gap in knowledge.
KW - laryngotracheal
KW - inhalation injury
KW - burns
KW - stenosis
KW - complications
KW - TRACHEAL STENOSIS
KW - AIRWAY RECONSTRUCTION
KW - SUBGLOTTIC STENOSIS
KW - LARYNGEAL
KW - MANAGEMENT
KW - TRACHEOPLASTY
KW - INTUBATION
KW - STRICTURES
KW - RESECTION
KW - SEQUELAE
UR - http://www.scopus.com/inward/record.url?scp=85149428181&partnerID=8YFLogxK
U2 - 10.1093/jbcr/irac058
DO - 10.1093/jbcr/irac058
M3 - Review article
C2 - 35486925
SN - 1559-047X
VL - 44
SP - 381
EP - 392
JO - Journal of Burn Care & Research
JF - Journal of Burn Care & Research
IS - 2
ER -