Total cervical tracheal stenosis: treatment by laser, dilation, and stenting.
Twelve patients with total cervical tracheal stenosis were treated by endoscopic laser excision (neodymium:yttrium aluminum garnet or carbon dioxide laser), bronchoscopic dilation, and prolonged stenting with a silicone T-tube. All patients had previous traumatic or prolonged endotracheal intubation requiring a tracheotomy and presented with aphonia as the major complaint. Multiple laser and dilation treatments were necessary in ten patients. Average duration of T-tube placement was 6 months. Excellent results (decannulation and good voice) were achieved in eight patients with a follow-up of 9 months to 6 years. Persistent granulation tissue and some degree of fibrosis were the most common complications (eight of 12 patients). Two patients died of medical complications. A high success rate with this endoscopic technique justifies this approach as our initial therapy, with open surgical techniques reserved for failure.
Shapshay
S M
SM
Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
Beamis
J F
JF
Dumon
J F
JF
D000328:Adult; D000368:Aged; D004106:Dilatation; D004724:Endoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D015607:Stents; D014135:Tracheal Stenosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*