Laryngotracheal stenosis: Experience of a hospital in Northwestern Mexico

Abstract

BACKGROUND. Laryngotracheal stenosis is a process of fibrosis, determined by various etiologies, congenital or acquired, such as traumatic, infectious, autoimmune diseases, that results in airway obstruction. Clinical manifestations may vary from speech alteration to severe breathing impairment, possibly leading to death. OBJECTIVE. To describe the evolution after surgical treatment of patients diagnosed with laryngotracheal stenosis. MATERIAL AND METHODS. We performed an observational, descriptive, retrospective cross-sectional study of a series of cases with a diagnosis of laryngotracheal stenosis surgically managed from January 2015 to January 2020. The results of the statistical analysis are represented by graphs and tables. RESULTS. We included 33 patients with mean age 42.6 years, predominantly male gender 19 (57.58%). The patients presented one or more comorbidities, such as overweight and obesity, which occurred in 54.5% of the cases. The etiology of stenosis was secondary to orotracheal intubation in most of the patients (69.69%) and the most common site was the trachea (42.42%). According to the Cotton-Myer classification, 51.5% of the patients were classified in grade III and, according to McCaffrey classification, 60.6% were included in grade II and III. 28 patients (84.8%) received surgery for stenosis, of which in 64.2% of the cases was endo-laryngeal dilatation. Re-stenosis occurred in 67.5%, successful decannulation was performed in 17.8% and mortality accounted for 7.1%. CONCLUSION. Although our surgical results pose multiple elements of improvement, the proportion of residual stenosis is still high and mortality is not different from that described by other authors around the world referring to airway surgery.