A Multi-Modality Surgical Management in Laryngeal Stenosis

Abstract

Introduction Postintubation laryngo-tracheal stenosis requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. This report presents surgically treated cases of laryngo-tracheal stenosis secondary to long-term intubation/ tracheostomy with review of the literature. Case Reports In this retrospective study, we present 5 cases (23-year-old male, 13 year old male, 22 year old male, 19 year old male and 33 year old female) of post-intubation/tracheostomy laryngo-tracheal stenosis (glottic/subglottic) stenosis in the year 2016 to 2017. Each patient was managed differently. A patient with history of multiple subglottic stenosis dilations and stenting underwent open surgical subglottic stenosis resection and anastomosis, LASER assisted resection of stenosis with stenting was done in a patient with history of dilation, LASER assisted resection and dilation followed by Mitomycin C application was done in another patient with history of poisoning, plain endoscopic dilation was done in one patient with history of head injury and Kashima’s Cordotomy with release of interarytenoid adhesion by LASER was done in one patient. Conclusion Resection of stenotic segment by open surgical anastomosis and laser assisted resection is a safe option for the treatment of subglottic stenosis following intubation without the need for repeated dilation. Endoscopic dilation can be reserved for unfit patients.

Keywords

• Laryngostenosis
• Intubation
• Endoscopy
• Cordotomy
• Tracheal Stenosis
• Anastomosis, Surgical