Trends in Subglottic Stenosis Management: Resource Utilization and Pediatric Otolaryngology Training. Laryngoscope 2022 Mar;132 Suppl 5:S1-S9
Date
08/04/2020Pubmed ID
32744780DOI
10.1002/lary.28927Scopus ID
2-s2.0-85088860478 (requires institutional sign-in at Scopus site) 1 CitationAbstract
OBJECTIVES/HYPOTHESIS: The role for endoscopic management in children with subglottic stenosis (SGS) has grown, but there are no data on resource utilization or the impact on surgical training in pediatric otolaryngology. This study hypothesizes that this shift has increased resource utilization and has impacted surgical training by shifting the focus toward more endoscopic techniques.
STUDY DESIGN: Retrospective database review.
METHODS: The Kids' Inpatient Database for 2003, 2006, 2009, and 2012 was queried for admissions with the diagnosis of SGS. Surgical caseload was studied using the Accreditation Council for Graduate Medical Education Accreditation data system for 2010 to 2017.
RESULTS: Admissions with SGS remained constant between 2003 and 2012. Hospital charges per admission did not change between 2003 and 2009 but increased in 2012. Tracheostomy decreased from 10.5% of admissions in 2003 to 6.8% in 2012. The percentage requiring repair of the larynx did not change; other operations on the larynx increased from 4.5% in 2003 to 11.6% in 2012. The median number of laryngoplasties performed per trainee decreased from 14 to nine between 2010 and 2017, whereas the number of laryngoscopy with intervention procedures increased from 34 to 56.
CONCLUSIONS: The evolution of SGS management appears to have led to a decrease in tracheostomy and an increase in certain procedures that may include endoscopic procedures. Recently, there has been a shift in airway surgical training, with trainees logging less open laryngotracheoplasty and more interventional laryngoscopy. Although these trends cannot be directly linked, the changes in trainee surgical experience may be justified by the decrease in larger open procedures and associated resource utilization.
LEVEL OF EVIDENCE: 2c Laryngoscope, 132:S1-S9, 2022.
Author List
McCormick MEAuthor
Michael E. McCormick MD Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentChild
Child, Preschool
Databases, Factual
Education, Medical, Graduate
Humans
Infant
Infant, Newborn
Laryngoplasty
Laryngoscopy
Laryngostenosis
Otolaryngology
Pediatrics
Retrospective Studies
Young Adult
