Surgical management of laryngotracheal stenosis in adults.

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Serval ID
serval:BIB_F1CFF4CC79E1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Surgical management of laryngotracheal stenosis in adults.
Journal
European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-rhino-laryngological Societies (eufos) : Affiliated With the German Society For Oto-rhino-laryngology - Head and Neck Surgery
Author(s)
George M., Lang F., Pasche P., Monnier P.
ISSN
0937-4477 (Print)
ISSN-L
0937-4477
Publication state
Published
Issued date
2005
Volume
262
Number
8
Pages
609-615
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The purpose was to evaluate the outcome following the surgical management of a consecutive series of 26 adult patients with laryngotracheal stenosis of varied etiologies in a tertiary care center. Of the 83 patients who underwent surgery for laryngotracheal stenosis in the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Lausanne, Switzerland, between 1995 and 2003, 26 patients were adults (> or = 16 years) and formed the group that was the focus of this study. The stenosis involved the trachea (20), subglottis (1), subglottis and trachea (2), glottis and subglottis (1) and glottis, subglottis and trachea (2). The etiology of the stenosis was post-intubation injury ( n = 20), infiltration of the trachea by thyroid tumor ( n = 3), seeding from a laryngeal tumor at the site of the tracheostoma ( n = 1), idiopathic progressive subglottic stenosis ( n = 1) and external laryngeal trauma ( n = 1). Of the patients, 20 underwent tracheal resection and end-to-end anastomosis, and 5 patients had partial cricotracheal resection and thyrotracheal anastomosis. The length of resection varied from 1.5 to 6 cm, with a median length of 3.4 cm. Eighteen patients were extubated in the operating room, and six patients were extubated during a period of 12 to 72 h after surgery. Two patients were decannulated at 12 and 18 months, respectively. One patient, who developed anastomotic dehiscence 10 days after surgery, underwent revision surgery with a good outcome. On long-term outcome assessment, 15 patients achieved excellent results, 7 patients had a good result and 4 patients died of causes unrelated to surgery (mean follow-up period of 3.6 years). No patient showed evidence of restenosis. The excellent functional results of cricotracheal/tracheal resection and primary anastomosis in this series confirm the efficacy and reliability of this approach towards the management of laryngotracheal stenosis of varied etiologies. Similar to data in the literature, post-intubation injury was the leading cause of stenosis in our series. A resection length of up to 6 cm with laryngeal release procedures (when necessary) was found to be technically feasible.
Keywords
Adolescent, Adult, Aged, Anastomosis, Surgical, Cricoid Cartilage/surgery, Female, Follow-Up Studies, Humans, Laryngostenosis/etiology, Laryngostenosis/pathology, Male, Middle Aged, Thyroid Cartilage/surgery, Tracheal Stenosis/etiology, Tracheal Stenosis/pathology, Tracheotomy, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 12:02
Last modification date
01/10/2019 7:20
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