Management of laryngotracheal stenosis — our experience

Abstract

Objective To describe our experience in the management of laryngotracheal stenosis (LTS).Study design Prospective study. Results There were 21 males and 9 females treated for LTS resulting from trauma (19), intubation (9) and congenital (2). Patients were divided into four groups based on surgical procedures they underwent: group I, endoscopy dilatation group (7 cases); group II, laryngotracheoplasty with Montgomery tube insertion (12 cases); group III, laryngotracheoplasty with Montgomery laryngeal stent insertion (5 cases) and group IV, cricotracheal resection with M-tube insertion (6 cases); The number of patients decannulated in group I, group II, group III and group IV were 4, 10, 0 and 5, respectively. We found statistically signifi cant difference between decannulated and nondecannulated group for site and length of stenosis. Materials and methods ConclusionPatients undergoing dilatation for LTS require multiple procedures. Open surgical exploration with stent has a better outcome than those with repeated dilatation.

Staged Laryngotracheoplasty in Adult Laryngotracheal Stenosis

“…Other etiologies include Wegener granulomatosis, chemical injury, and gastroesophageal reflux disease. 1,2 Instrumentation of the trachea is by far the predominant cause of LTS in adults, with multiple series reporting intubation or tracheotomy as causes in more than 80% of patients. 3,4 The length, location, and severity of stenosis must all be considered in the treatment of LTS.…”

“…5 These are safe and welltolerated but are associated with high rates of recurrence typically requiring repeated procedures. 2 Alternatively, open surgical approaches can lead to long-term decannulation but carry higher risks of morbidity and mortality. 2 There are 2 general open surgical strategies.…”

“…2 Alternatively, open surgical approaches can lead to long-term decannulation but carry higher risks of morbidity and mortality. 2 There are 2 general open surgical strategies. 6 The first approach involves full resection of the stenotic segment of trachea, which may or may not include the cricoid ring, with primary anastomosis.…”

A Comparative Study of Cricotracheal Resection and Staged Laryngotracheoplasty for Adult Subglottic Stenosis

“…1,2 Other causes of SGS include external cervical trauma, laryngopharyngeal reflux, and autoimmune disease (ie, granulomatosis with polyangiitis). 4 The 2 general strategies of open surgical approaches include either a trough resection with reconstruction or complete resection with re-anastomosis: laryngotracheoplasty (LTP) or cricotracheal resection (CTR). Endoscopic treatments such as balloon dilation, CO 2 laser incision, and antineoplastic agent application are safe, well-tolerated, and often successful in mild SGS.…”

“…2 Definitive treatment with long-term decannulation can be achieved through open surgical approaches, but these carry greater risks. 4 The 2 general strategies of open surgical approaches include either a trough resection with reconstruction or complete resection with re-anastomosis: laryngotracheoplasty (LTP) or cricotracheal resection (CTR). Laryngotracheoplasty creates an expansion of the airway structure and excision of stenotic tissue without circumferential resection.…”