Ten years of tracheal and laryngotracheal stenosis surgery: what we have learned and how we do it

Abstract

Introduction: The management of tracheal and laryngotracheal stenosis is a challenge in otolaryngology; its results are the result of experience acquired over many years. Current evidence-supports the concept that surgery leads to good results in most cases; however, experience in these techniques is usually available in a few centers. Aim: Present a clinical series of cases with airway stenosis who underwent surgical intervention, emphasizing our preoperative and postoperative management and results. Methods: Retrospective review of patients who underwent surgery for tracheal or laryngotracheal stenosis, from 2014 to 2024 in Hospital Guillermo Grant Benavente, Concepción. We considered success to be decan- nulation in patients previously tracheostomized and in patients without tracheostomy who were able to lead a normal life without limitations. Results: 41 patients underwent surgery; 43 surgeries were performed, 41 primary and 2 reoperations. The primary surgeries perfor- med were laryngotracheal reconstruction (13/41, 31,7%), cricotracheal resection (11/41, 26,8%), and tracheal resection and anastomosis (17/41, 41,5%). Most were performed in one stage (35/41). The reconstructions were all intubated or stented postoperatively. The first surgery success rate was 95%, increasing to 100% success when considering reoperated cases. Conclusions: Surgical treatment of tracheal and laryngotracheal stenosis should be individualized to each patient and performed in specialized centers. In our experience, most of the cases achieved satisfactory postoperative results, achieving decannulation or resolu- tion of symptoms.