title: [The constitutional approach to the choice of the surgical strategy for the treatment of chronic post-traumatic laryngeal stenoses].
abstract: We have developed the algorithm for the choice of the surgical strategy for the treatment of chronic post-traumatic laryngeal stenosis with the purpose of enhancing the effectiveness of the management of the patients presenting with this condition. The proposed approach envisages obtaining anthropometric characteristics of the patients, determination of the type of his (her) neck and constitution, construction of the regressive models of the clinically significant laryngometric parameters based on the results of the clinical observations including the dimensions of the glottal fissure and the position of the vocal folds, calculations of the size of the autotransplant and the length of the T-shaped tube based on the results of the mathematical analysis of the anthropo- and organometric characteristics of the concrete patient, the laryngoplastic and prosthetic treatment of the newly formed laryngo-tracheal passage. The present study included 71 patients at the age from 23 to 68 years presenting with chronic paralytic (31%) and combined (69%) laryngeal stenosis. They were examined with the use of computed tomography of the larynx and the trachea, anthropometric, endoscopic, and spirometric techniques. The following methods were used to treat the patients: extralaryngeal laterofixation of the vocal fold (n=22), extralaryngeal laterofixation of the vocal fold with the stenting using a T-shaped silicone tube (n=43), dissection of the scars remaining after the previous laryngoplastic interventions with the redressement of the innominate cartilage and laryngeal stenting (n=6). The inclusion of the proposed algorithm in the program of the surgical treatment of chronic post-traumatic laryngeal stenosis taking into consideration the individual characteristics of the neck and the body constitution of the concrete patients made it possible to provide successful medical rehabilitation for 68 (95.8%) patients presenting with chronic paralytic and combined laryngeal stenosis.
authors.affiliation: I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991.
authors.forename: S V
authors.initials: SV
authors.lastname: Starostina
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007829:Laryngostenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications; D055815:Young Adult