[Analysis of traumatic laryngotracheal stenosis in 63 cases].
OBJECTIVE
To explore the surgical treatment and the principle of selecting approaches in traumatic laryngotracheal stenosis.


METHODS
Sixty three cases of traumatic laryngotracheal stenosis treated in the Department of Otolaryngology, Head and Neck Surgery, Chinese People's Liberation Arauy General Hospital from 1993-2006 were reviewed. The surgical treatment and the effects were analyzed.


RESULTS
Among the 63 cases, 99 operations were accomplished in total, excluding tracheotomy and the closure operation for the fistula. Forty patients had experienced one operation (63.5%), 15 cases (23.8%) had 2 operations, 5 cases had 3 operations, 2 cases had 4 operations, and one case had 6 operations. Fifteen initially estimated as laryngotracheal stenosis with intact framework had supporting laryngoscopic surgery, 11 cases decannulated successfully after single operation. Primary laryngotracheal split and plasticity with T tube implantation were accomplished in 36 cases, with 20 cases decannulated. Among 10 cases experienced laryngotracheal split, skin graft in laryngotracheal cavity with T tube implantation, 7 decannulated. Among 6 cases of laryngotracheal split, pedicled hyoid flap transfer for reconstruction of the laryngotracheal framework defect, 4 cases decannulated. Tracheal and cricotracheal resection and end-end anastomosis were performed in 9 cases, 7 cases decannulated after single procedure. Two cases of subglottic stenosis with tracheoesophageal fistula were repaired with laryngotracheal plasticity in single procedure successfully. Fifty seven patients were decannulated after different procedures with variable hoarseness, within 6 months to 5 years follow-up. Six cases failed in decannulation. The decannulation rate was 90.5%.


CONCLUSIONS
Traumatic laryngotracheal stenosis is a complex problem that usually needs a longer time for reconstruction and a different ways of approaches. It is necessary to evaluate the laryngotracheal framework defect, the degree and extension of stenosis systematically before operation for surgical planning.
Liu
Liang-fa
LF
Department of Otorhinolaryngology, Head and Neck Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China. liuliangfa301@263.net
Wu
Wen-ming
WM
Wang
Jia-ling
JL
Feng
Bo
B
Zhao
Hui
H
Huang
De-liang
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult