Laryngo-tracheal stenosis. Our experience

Abstract

Introduction: Laryngo-tracheal stenosis is a condition difficult to manage and obtain results which permit the person who suffers it recover phonorespiratory and deglutory function. This is not always pssible to achieve. Aim: Present a clinical series of patients with stenosis of the VAS and underwent surgery. A secondary objective is to assess whether or not there are similar technical differences between age groups. Material and method: We present a retrospective analysis of patients surgically treated by the authors. They present demographic description cases, site of stenosis, type of intervention according to age; percentage of successful decannulation after one or more interventions; reoperation, type of graft and stents used. The group was divided into pediatric and adult. Statistical analysis was performed with X and Fisher. Results: The case mix consists of 88 patients who underwent surgery to repair laryngo-tracheal stenosis. Children under 18 years correspond to 45 cases (51%). The percentage of success in the first surgery is 75.6% (34/45 cases) in children under 18 and 76.7% (33/43 cases) over 19 years. 15/21 failed cases were reoperated in the first instance; 13 of them were decannulated increasing success to 90.9%. Reoperation failure and still unresolved, 8 cases. Surgical technique used was laryngotracheal reconstruction with costal cartilage graft either anterior or posterior being subglottic the site of stenosis. Success rate to this technique is 68.3%. In patients under 18 years old is 71% success and over 18 years 60%. For tracheal stenosis, tracheal resection with end to end anastomosis has a success rate of over 90% and it is performed mostly in the age group over 18 years. Conclusion: We obtained success rates in decannulation similar to those reported internationally. A complex stricture remains a challenge to achieve its decannulation. In these cases combined resections and reconstructions are used.