Therapeutic Problems in Laryngo-Tracheal Stenoses

Abstract

History revealed iatrogenic injury (tracheostomy, intubation, artificial respiration) to be the reason for tracheal stenosis in each of our 32 cases (18 female, 14 male). So far 23 cases have been treated successfully and they live without a cannula; seven are still under treatment, while two patients died (severe heart-attack, spontaneous pneumothorax) and one refused further treatment. We were relatively successful in six cases of sleeve resection. All other 26 cases were treated by creating a tracheal groove, in which tracheal mucosa and skin of the neck were joined and the caudal end mostly kept open by using a pedicle skin flap. Intrathoracic stenoses require a sternotomy. An additional thyroidectomy and lateral traction to the tracheal walls by using loops out of the sternomastoid muscle became necessary in many cases and we obligatorily used tamponades of plastic inlay bolts, the average time of treatment being 8 months.

Indirect Measurement of Laryngeal and Tracheal Resistance

“…Long, Soft Tracheal Stenoses: Therapy Using Grooves. We had to install tracheal grooves (Lange, 1975) in all patients suffering from long, soft tracheal stenoses and in cases who could not be fitted with external Schobel stents. Figure 5 shows the results.…”

“…Several operative measures are often needed. Figure 7 shows the results o f treatment {Lange, 1975;Weerda, 1974). We notice, from the illustration, that normal tracheal diameters of over 15 mm and the corresponding airway resistance of 15 mm f^O /Fa'sec could only seldom be achieved.…”