[Treatment of severe subglottic laryngotracheal stenosis using hyoid graft with sternohyoid muscle flap].
OBJECTIVE
To evaluate the possibility and reliability of the hyoid-sternohyoid graft transfer in the correction of server subglottic laryngotracheal stenosis, and delineate the operation skills and clinical results.


METHODS
Seven patients with severe subglottic stenosis underwent laryngotracheal reconstruction using the hyoid grafts with sternohyoid muscle flaps (HG-SHMF). Five of these patients had traumatic subglottic stenosis, one with scar tissue of unknown etiology arising in the subglottic region, another with tracheal narrowing caused by inhalation of hydrochloric acid.


RESULTS
All seven patients were successfully decannulated with moderate good voice. The average time from reconstruction to decannulation was 15.4 months. The stent was endoscopically removed with a range of 3 to 22 months; the mean time required for stenting was 9.6 months. Two patients who received additional salvage reconstruction procedures because of graft or stent displacement were extubated with improved voices and satisfactory airway.


CONCLUSIONS
The HG-SHMF transfer was a single-stage reconstruction, relatively simple procedure that can restore an adequate airway and a good voice. Patients undergoing laryngotracheal reconstruction with HG-SHMF must have regular, long-term follow-up since graft displacement and recurrent granulation tissue or scar reformation can cause restenosis after an initially successful surgery. This procedure should be used in a large number of patients to further test its reliability.
Qin
Yong
Y
Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China. qinyong@public.bta.net.cn
Xiao
Shui-fang
SF
Li
Zhi-guang
ZG
Guo
Min
M
Zheng
Zhong-li
ZL
D000293:Adolescent; D000328:Adult; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D014135:Tracheal Stenosis / Q000601:surgery*