dataset · Zenodo (CERN European Organization for Nuclear Research)
Acquired laryngotracheal stenosis involves airway narrowing typically evaluated via endoscopy. This retrospective cross-sectional study examined the relationship between plain neck radiography measurements and endoscopic Cotton-Myer severity grades in 119 patients aged 12 years and older with confirmed nonmalignant stenosis. Airway calibres recorded on anteroposterior and lateral radiographs were categorised into ordered intervals from no detectable lumen up to 20 millimetres. The findings showed a strong inverse correlation between radiographic calibre categories and endoscopic severity grades. Radiographic cut-offs of five millimetres or less achieved high sensitivity and moderate specificity for identifying severe stenosis. However, because the investigation studied only known cases, utilised categorical rather than continuous measurements, and lacked reader-level data, these radiographic assessments cannot currently be used for initial diagnosis, exact continuous thresholding, or clinical triage decisions.
Laryngotracheal stenosis narrows the windpipe and can severely restrict breathing, usually necessitating invasive endoscopic evaluation to determine severity. Demonstrating that simple neck radiographs correlate closely with endoscopic grades provides insight into non-invasive airway assessment. However, because the findings apply solely to pre-diagnosed patients and lack reader-level validation, radiography cannot replace standard diagnostic procedures without further research.
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Abstract Objective: To determine the association of anteroposterior (AP) and lateral neck radiographic airway categories with endoscopic Cotton-Myer severity in patients with confirmed acquired laryngotracheal stenosis (LTS). Methods: This retrospective cross-sectional study included patients aged 12 years or older with acquired nonmalignant LTS, a recorded Cotton-Myer grade, and paired AP and lateral radiographic entries (2005-2024). Airway caliber was stored as ordered categories (no detectable lumen, <5, 5, 10, 15, or 20 mm). Associations with grade were evaluated using Spearman correlation with bootstrap intervals. Within-disease discrimination of grades III-IV versus I-II was exploratory. Results: Of 175 database records, 119 met eligibility criteria. Grades I, II, III, and IV comprised 7, 24, 68, and 20 participants. AP and lateral categories were inversely correlated with grade (Spearman ρ, -0.862; 95% bootstrap CI, -0.912 to -0.794; and -0.858; 95% CI, -0.909 to -0.789). At the observable boundary comprising no detectable lumen, <5 mm, and 5 mm, AP counts were 85 true-positive, 7 false-positive, 3 false-negative, and 24 true-negative observations (sensitivity, 96.6%; lower-grade specificity, 77.4%; ordinal AUC, 0.932). Lateral counts were 83, 6, 5, and 25, respectively (sensitivity, 94.3%; specificity, 80.6%; AUC, 0.938). Grade II-versus-III AUCs were lower (AP, 0.886; lateral, 0.896). Conclusion: Ordered radiographic airway categories were strongly associated with endoscopic severity among patients already known to have LTS. The case-only design, categorical measurements, and absent reader-level data preclude claims of LTS diagnosis, an exact continuous threshold, or clinical triage. Keywords: acquired laryngotracheal stenosis; airway obstruction; Cotton-Myer grading; plain neck radiography; severity stratification
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DOI: 10.5281/zenodo.22082270
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