title: Single-staged laryngotracheal reconstruction for idiopathic tracheal stenosis.
abstract: BACKGROUND
  This study retrospectively evaluated the results of surgically treated idiopathic tracheal stenosis.
  
  
  METHODS
  Of the 220 patients surgically treated for idiopathic subglottic and tracheal stenosis in the participating hospitals, we reviewed the surgical records of all patients with idiopathic tracheal stenosis. This subgroup required resection of all of the involved mucosa but frequently had undergone more conservative treatments that damaged the tracheal mucosa and cartilage and complicated the definitive surgical treatment.
  
  
  RESULTS
  During the study period, 60 women (93.8%) and 4 men (6.2%), who were a mean age of 50 years (range, 19 to 77 years), were surgically treated for idiopathic tracheal stenosis, with no operative deaths. Of these 64 patients, 38 (59.3%) had undergone previous treatments in other centers: dilation, 26 (40.6%); laser only, 19 (31%); laser plus tracheal prosthesis, 5 (7.8%); tracheostomy, 7 (11.6%); T tube, 2 (3%); and laryngotracheal operations, 5 (7.8%). All patients were treated with a single-staged tracheal or laryngotracheal operation, of which 59 (98%) successful. Four of the most complex stenoses, with vocal cords and cricoid plate involvement, underwent reoperation for restenosis or larynx inconsistency. One patient was considered biologically unfit for reoperation and required a permanent T tube for restenosis. Half of the operations were temporary tracheostomies with T tube for larynx modelling. The most frequent postoperative complications were dysphonic voice in 10 patients (although in 7 instances this began months or years before the operation), granulation tissue in 10, aspiration in 3, and wound infections in 2.
  
  
  CONCLUSIONS
  Idiopathic stenosis occurred predominantly (90% of cases) in women. Single-staged laryngotracheal correction was successful in 97%. Technique selection, with or without temporary laryngeal stenting, must be individualized with respect to the vocal cords' mobility, function, and distance from the stenosis.
authors.affiliation: General Thoracic Surgery Department, Hospital Clínico, Universidad de Valencia, Valencia, Spain. morcillo.alf@gmail.com
authors.forename: Alfonso
authors.initials: A
authors.lastname: Morcillo
authors.forename: Richard
authors.initials: R
authors.lastname: Wins
authors.forename: Abel
authors.initials: A
authors.lastname: Gómez-Caro
authors.forename: Marina
authors.initials: M
authors.lastname: Paradela
authors.forename: Laureano
authors.initials: L
authors.lastname: Molins
authors.forename: Vicente
authors.initials: V
authors.lastname: Tarrazona
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D055815:Young Adult