Thyrotracheal Anastomosis for Combined Laryngotracheal Stenosis: Experience in 11 Cases

Choi, Han Young; Ju, Eun Jeong; Cho, Syung Hyun; Kwon, Soon Young; Yoo, Hong Kyun; Jun, Byung Sun; Kim, Hye Jeong; Choi, Jong Ouck

Abstract

BACKGROUND AND OBJECTIVES: The combined Laryngotracheal stenosis produces cripling complications of respiratory and phonation difficulty. The area between cricoid cartilage and first tracheal ring is the most common site of stenosis and is the most difficult area to manage, therefore, appropriate selection of surgical method is the important factor determining the success of treatment. The authors treated laryngotracheal stenosis with thyrotracheal anastomosis and here we report the results and problems of thyrotracheal anastomosis to provide aid in the management of laryngotracheal stenosis.
MATERIALS AND METHODS
Authors retrospectively studied 11 cases of laryngotracheal resection with thyrotracheal anastomosis patients for clinical characteristics, site and degree of stenosis, operation technique such as granulation tissue removal under bronchoscopy, CO2 laser excision, insertion of T-tube, insertion of laryngeal stent, and its results.
RESULTS
1) Decannulation was possible in seven cases (63.6%). 2) The success rates of patients under the ages of 20years was 80%, patients with normal vocal cord movement was 85.7%. 3) The patients with residual neurologic symptom, or with decreased coughing reflex failed in decannulation.
CONCLUSION
Treatment of combined laryngotracheal stenosis is very difficult and our study showed a success rate of 63.6%. Laryngotracheal resection and end to end thyrotracheal anastomosis showed to be the most effective treatment method and in general the patients under the ages of 20 years, or with normal vocal cord movement showed better prognosis. Therefore, a radical treatment planning with efforts to reduce complication at this group may produce satisfactory results in the management of laryngotracheal stenosis.