title: End-to-end anastomosis in the management of laryngotracheal defects.
abstract: OBJECTIVE
  To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection.
  
  
  METHODS
  A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis.
  
  
  RESULTS
  Length of stenosis was 1.7-4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n = 4), cricotracheal anastomosis (n = 2) and thyrotracheal anastomosis (n = 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n = 1), subcutaneous emphysema (n = 1), temporary unilateral vocal fold palsy (n = 1), granulation tissue development (n = 1), and restenosis (n = 2).
  
  
  CONCLUSIONS
  End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.
authors.affiliation: Otorhinolaryngology Department,Cerrahpasa Medical Faculty,Istanbul University,Turkey.
authors.forename: E D
authors.initials: ED
authors.lastname: Gozen
authors.affiliation: Otorhinolaryngology Department,Cerrahpasa Medical Faculty,Istanbul University,Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yener
authors.affiliation: Otorhinolaryngology Department,Cerrahpasa Medical Faculty,Istanbul University,Turkey.
authors.forename: Z B
authors.initials: ZB
authors.lastname: Erdur
authors.affiliation: Otorhinolaryngology Department,Cerrahpasa Medical Faculty,Istanbul University,Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Karaman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003413:Cricoid Cartilage / Q000601:surgery; D005260:Female; D006097:Granulation Tissue; D006801:Humans; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000209:etiology; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology; D055815:Young Adult
keywords: Acquired Subglottic Stenosis; Airway Obstruction; Tracheal Stenosis