title: Acquired subglottic stenosis: aetiological profile and treatment results.
abstract: OBJECTIVE
  To analyse the aetiological profile and surgical results of patients with acquired chronic subglottic stenosis, and formulate a surgical scheme based on an audit of various surgical procedures.
  
  
  METHODS
  Thirty patients were treated by 65 procedures (31 endoscopic and 34 external) between 2004 and 2009.
  
  
  RESULTS
  Isolated subglottic stenosis was noted as unusual in the majority (27 cases), demonstrating contiguous tracheal or glottic involvement. The major aetiologies were intubation injury (n = 8) and external injury (n = 21) (i.e. blunt trauma, strangulation or penetrating injury). Vocal fold immobility and cartilage framework involvement were frequent with external injury and infrequent with intubation injury. Luminal restoration was achieved by endoscopic procedures in 2 cases, external procedures in 19 cases, and external plus adjuvant endoscopic procedures in 8 cases. The preferred surgical options were: endoscopic procedures, restricted to short, recent, grade I or II mucosal stenosis cases; and external procedures for all other stenosis situations, including isolated subglottic (anterior cricoid split plus cartilage graft), subglottic and glottic or high subglottic (anterior plus posterior cricoid split with cartilage graft), and subglottic and tracheal (cricotracheal resection with anastomosis).
  
  
  CONCLUSIONS
  External injury stenosis has a worse profile than intubation injury stenosis. Anatomical categorisation of subglottic stenosis guides surgical procedure selection. Endoscopic procedures have limited indications as primary procedures but are useful adjunctive procedures.
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: S
authors.initials: S
authors.lastname: Pookamala
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: A
authors.initials: A
authors.lastname: Thakar
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: K
authors.initials: K
authors.lastname: Puri
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: P
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: R
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Surgery,All India Institute of Medical Sciences,New Delhi,India.
authors.forename: S C
authors.initials: SC
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003413:Cricoid Cartilage / Q000293:injuries* / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D019838:Neck Injuries / Q000150:complications* / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D014132:Trachea / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult