The duration of tracheostomy dependence in patients with juvenile-onset recurrent respiratory papillomatosis

Abstract

Background

Tracheostomy is a vital therapy for juvenile-onset recurrent respiratory papillomatosis (JORRP) to maintain an adequate airway in an emergency, yet the relationship between cannulation duration and prognosis has not been extensively explored.

Objectives

To investigate the predictive influence of the duration of tracheostomy dependence on JORRP remission.

Materials and methods

A retrospective review of JORRP patients (n = 77) with tracheostomy treated in Beijing Tongren Hospital was performed.

Results

The rate of decannulation was 72.7%. After decannulation for one year, the percentage of distal spread fell from 42.9 to 30.4%. Twenty-six of 77 patients (33.8%) had remission of their disease, 40 (51.9%) continued to have active disease while 11 (14.3%) died during follow-up. The cannulation duration was positively correlated with the overall duration of this disease (r = 0.6). The cut-off point of 34.9 months for cannulation duration indicated the highest predictive value of remission. Duration of cannulation >34.9 months (OR = 0.33) and distal spread (OR = 0.29) decreased odds of remission.

Conclusion

The study demonstrates that the time span before decannulation indicates the severity of disease and cannulation aggravates the distal spread. Patients with cannulation duration ≤ 34.9 months after tracheostomy are prone to possess a relatively pleasant prognosis.

Chinese Abstract

背景：气管切开术是治疗青少年复发性呼吸道乳头状瘤病（JORRP）的重要疗法, 可用于紧急情况下维持适当的气道, 但插管持续时间与预后之间的关系尚未得到广泛探讨。

目的：研究气管切开术依赖持续时间对 JORRP 缓解的预测影响。

材料和方法：对在北京同仁医院接受气管切开术的 JORRP 患者（n = 77）进行了回顾性研究。

结果：拔管率为72.7%。拔管一年后, 远端扩散的百分比从 42.9% 下降到 30.4%。 77 名患者中有 26 名（33.8%）的病情得到缓解, 40 名（51.9%）病情持续, 11 名（14.3%）在随访期间死亡。插管持续时间与该病的总持续时间呈正相关（r = 0.6）。插管持续时间的截止点为 34.9 个月, 是病情缓解的预测值最高点。插管持续时间 > 34.9 个月 (OR = 0.33) 和远端扩散 (OR = 0.29) 降低了缓解的几率。

结论：该研究表明, 拔管前的时长指示疾病的严重程度, 并且插管加重了远端扩散。气管切开术后插管时间 ≤ 34.9 个月的患者预后相对较好。

Keywords:

• Juvenile-onset recurrent respiratory papillomatosis
• tracheostomy
• cannulation duration
• prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the [The Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Municipal Adiministration of Hospitals] under Grant [number XTCX201823]; and [Beijing Administration of Traditional Chinese Medicine] under Grant [number JJ-2020-17].