{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:06:32Z","timestamp":1784603192269,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify laryngotracheal morphological changes after tracheostomy using CT, compare findings between surgical open tracheostomy (SOT) and percutaneous dilatational tracheostomy (PDT) in a chronically ventilated population and identify CT\u2010based predictors of successful decannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 82 chronically ventilated patients who underwent CT \u2265\u20094\u2009weeks after tracheostomy. Lumen areas were measured at the cricoid, suprastomal, and distal tracheal levels by standardized triplicate tracing. Cartilage fractures, stoma position, and wall thickness were characterized. Radiological predictors of decannulation were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following tracheostomy, the cricoid lumen area decreased by 37% (mean difference: \u221288.9\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI: \u2212113.2 to \u221264.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and the suprastomal lumen area by 53% (\u2212135.1\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI: \u2212160.2 to \u2212110.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The distal tracheal lumen was unchanged (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009NS). Tracheal wall thickness increased from 1.93 to 2.89\u2009mm (+0.96\u2009mm, 95% CI: 0.80\u20131.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Cartilage fractures were identified in 63.4% of patients. In total, 22% of stomas were placed at or above the cricoid level. None of the 14 patients with cricoid\u2010level stoma were successfully decannulated (0% vs. 29.4%; Fisher exact\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Suprastomal fibrotic or cartilaginous block (partial or complete) was more common in non\u2010decannulated patients (63.3% vs. 35.0%; Fisher exact\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038; OR\u2009=\u20090.32, 95% CI: 0.11\u20130.92). No significant SOT\u2013PDT differences were found in any outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long\u2010term tracheostomy causes significant laryngotracheal morphological changes with no structural differences between SOT and PDT. Cricoid\u2010level stoma and suprastomal fibrotic block are significant predictors of decannulation failure, supporting CT assessment before or after failed decannulation to identify candidates for airway intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70756","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:00:28Z","timestamp":1784602828000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>CT<\/scp>\n                    Assessment of Laryngotracheal Changes After Surgical and Percutaneous Tracheostomy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-4929","authenticated-orcid":false,"given":"Sapir","family":"Pinhas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5464-0586","authenticated-orcid":false,"given":"Noam","family":"Bartov","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meital","family":"Adi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8349-8534","authenticated-orcid":false,"given":"Yael","family":"Shapira\u2010Galitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6136-5762","authenticated-orcid":false,"given":"David","family":"Kiderman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6639-9219","authenticated-orcid":false,"given":"Raviv","family":"Allon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kaplan Medical Center  Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"8","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.4187\/respcare.10551056","article-title":"Tracheostomy: Why, When, and How?","volume":"55","author":"Durbin C. 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K.","year":"1998","journal-title":"Intensive Care Medicine"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.70252"},{"issue":"6","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","DOI":"10.1097\/CCE.0000000000001102","article-title":"Reducing Tracheostomy\u2010Related Acquired Pressure Injury by Flipping the Ventilator Circuit Position","volume":"6","author":"Niroula A.","year":"2024","journal-title":"Critical Care Explorations"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11160"},{"issue":"4","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","DOI":"10.1002\/oto2.70033","article-title":"Investigating Predictors of Decannulation Through Endoscopic Approach in Patients With Tracheostomy and Peristomal Subglottic Stenosis","volume":"8","author":"Wehbi N.","year":"2024","journal-title":"OTO Open"},{"issue":"5","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1002\/hed.23665","article-title":"Diagnosis and Conservative Management of Late Tracheotomy Complications in Chronic Ventilator\u2010Dependent Patients","volume":"37","author":"Ilan O.","year":"2015","journal-title":"Head & Neck"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70756","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70756","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70756","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:00:33Z","timestamp":1784602833000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":23,"alternative-id":["10.1002\/lary.70756"],"URL":"https:\/\/doi.org\/10.1002\/lary.70756","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"2026-04-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70756"}}