Single‐stage surgical repair of benign laryngotracheal stenosis in adults

Abstract

Benign laryngotracheal stenosis in the adult patient can be repaired successfully using a strategy of two single-stage surgical procedures. All patients had good or satisfactory functional results. A multidisciplinary approach was essential to achieve these good results.

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

“…While the above referenced studies were mainly focused on "surgical success" (i.e., recurrence of stenosis, successful decannulation, reintervention rates), various authors have advocated that functional outcome parameters, such as pulmonary-, voice-, and swallowing-related functions, are equally as important in defining treatment success (8). However, few studies have published these patient-reported functional outcomes after tracheal surgery in adults (3).…”

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.…”

“…[6][7][8] However, treatment of longsegment stenoses, typically beyond 6 tracheal rings, and stenoses that extend high within the larynx has limited success with primary resection. 1 In such challenging cases, staged LTP has been suggested to produce high decannulation rates. Laryngotracheoplasty is a general term encompassing wide ranges of surgical techniques and protocols.…”

Endobronchial brachytherapy provides excellent long-term control of recurrent granulation tissue after tracheal stenosis

“…Surgical resection remains the standard of care of benign tracheal stenosis (2,19). However, many patients especially after prolonged intubation are not candidates for tracheal resection.…”

“…Although surgical resection is the standard of care in the repair of these cases (2,3), many patients however are unable to medically tolerate a surgical procedure. In those cases, a combination of local therapy including laser ablation of granulation tissue and manual dilation and metallic stenting can be used to provide a palliative effect (4e6).…”