Clin Exp Otorhinolaryngol.  2009 Dec;2(4):211-214. 10.3342/ceo.2009.2.4.211.

Successful Treatment of Tracheal Stenosis with Slide Tracheoplasty after the Failure of Resection with End-to-End Anastomosis

• Lee SY
• Lee SM
• Park SR
• Chang JW
• Chung TS
• Choi HS

• KMID: 1466501
• DOI: http://doi.org/10.3342/ceo.2009.2.4.211

Abstract

The combined effects of inhaled irritant gases and heat in burn patients can result in the development of laryngotracheal strictures. Several factors could adversely affect the development of tracheal stenosis and cause the growth of granulation tissue. Yet the current treatment options for this condition are limited because of the paucity of case reports. We report here on a case of a patient who experienced recurrent upper tracheal stenosis after an inhalation injury. She displayed repetitive symptoms of stenosis even after several laryngomicrosurgeries and resection with end-to-end anastomosis. Finally, 5 yr after the burn injury, slide tracheoplasty was successfully performed and the postoperative check-up findings and the increased airway volume seen on imaging were all satisfactory.

Keyword

Inhalation burn; Tracheal stenosis; Resection with end-to-end anastomosis; Slide tracheoplasty

MeSH Terms

Burns
Burns, Inhalation
Constriction, Pathologic
Gases
Granulation Tissue
Hot Temperature
Humans
Inhalation
Tracheal Stenosis
Gases

Figure

• 

  Fig. 1 A neck CT scan.Five year after the resection with end-to-end anastomosis surgery, the scan reveals a narrowed airway with hour-glass-shaped tracheal rings at the 6th level of the cervical spine. The narrowest diameter of the trachea was about 0.6-0.7 cm.

• 

  Fig. 2 The slide tracheoplasty procedure and the operative findings.We performed a transverse midline neck incision along with a thyroid split. Three circumferential narrowed tracheal rings were observed, and transection of the stenotic trachea was performed at the narrowest midpoint; thick fibrous mucosal changes were then observed. The proximal half of the trachea was split along its anterior wall, while the distal segment was split along its posterior wall. The right angle corners where the vertical incisions met the transverse incision were trimmed. Both ends of the trachea were then anastomosed.

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  Fig. 3 Objective improvement of the airway.Objective improvement of the airway was confirmed by using a 3D volume rendering technique at the levels 15 mm above and below the stenosis area on the CT image. (A) The preoperative transected area of 28.7 mm2 increased to (B) 75.4 mm2 postoperatively. (C) The preoperative selected airway volume of 1,082.6 mm3 had increased to (D) 1,767.8 mm3 postoperatively.

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