Prognostic value of the ELS grading system for assessment of laryngotracheal stenosis in children

Background: In 2015, the European Laryngological Society (ELS) published a consensus paper in which a new classification system for laryngotracheal stenosis (LTS) was presented. This retrospective analysis investigates the classificationʼs reliability and prognostic value regarding the outcome of surgical airway reconstruction in a pediatric population. Materials and methods: A total of 191 pediatric patients treated with cricotracheal or segmental resection were included. The ELS score was retrospectively calculated using information on the degree of stenosis, number of involved subsites, and presence of significant comorbidity. Reliability and prognostic value for airway restoration, surgical complications, and need of additional treatment were analyzed. Results: Decannulation rate differed with regards to etiology (96% for acquired LTS, 86 and 87% for congenital and posttraumatic LTS, respectively). Decannulation was significantly more likely with 1–2 involved subsites than in LTS with 3–4 subsites (97 vs. 72%). The number of additional interventions after reconstruction was largely dependent on the number of involved subsites and the presence of significant comorbidity. Conclusion: The ELS score for LTS permits prognostically reliable classification and is thus a valuable tool for decision making, counseling of patients and relatives, and comparing treatment outcomes.