Combined infrahyoid and inferior constrictor muscle release for tension-free anastomosis during primary tracheal repair.
Although tracheal stenosis is not a common clinical entity, it still presents a significant management problem, despite recent endoscopic advances. Surgical correction by resection and primary anastomosis is the preferred treatment, provided the repair can be performed without excessive tension. Various release techniques have been described in order to achieve mobility and, thereby, a tension-free anastomosis. This article presents a combined infrahyoid muscle and inferior constrictor muscle release to assure maximum mobility of the laryngotracheal complex, thus allowing tension-free closure. A series of ten patients who underwent primary repair using the combined technique is presented, and the operative technique is described. The indications, age, length of stenosis, and minimum 1 year followup of these patients are presented, as well as perioperative management and complications. The success rate with this technique is 90%.
Biller
H F
HF
Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029.
Munier
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006928:Hyoid Bone; D007442:Intubation, Intratracheal; D007821:Laryngeal Muscles / Q000601:surgery*; D008875:Middle Aged; D009334:Neck Muscles / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques; D013957:Thyroid Cartilage; D014132:Trachea / Q000601:surgery; D014135:Tracheal Stenosis / Q000601:surgery*