Analysis of traumatic laryngotracheal stenosis in 63 eases
10.3760/cma.j.issn.1673-0860.2009.05.011
- VernacularTitle:外伤性喉气管狭窄63例临床分析
- Author:
Liang-Fa LIU
1
;
Wen-Ming WU
;
Jia-Ling WANG
;
Bo FENG
;
Hui ZHAO
;
De-Liang HUANG
Author Information
1. 解放军总医院
- Keywords:
Laryngostenosis;
Tracheal stenosis;
Tracheoesophageal fistula;
Wounds and injuries;
Otorhinolaryngologic surgical procedures;
Dilatation;
Stents
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2009;44(5):389-394
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical treatment and the principle of selecting approaches in traumatic laryngotracbeal stenosis. Methods Sixty three cases of traumatic laryngotracheal stenosis treated in the Department of Otolaryngology, Head and Neck Surgery, Chinese People's l,iberation Arauy General Hospital from 1993 - 2006 were reviewed. The surgical treatment and the effects were analyzed. Results Among the 63 cases, 99 operations were accomplished in total, excluding tracheotomy and the closure operation for the fistula. Forty patients had experienced one operation (63.5%), 15 cases (23.8%) had 2 operations, 5 cases had 3 operations, 2 cases had 4 operations, and one case had 6 operations. Fifteen initially estimated as laryngotracheal stenosis with intact framework had supporting laryngoscopic surgery, 11 cases decannulated successfully after single operation. Primary laryngotracheal split and plasticity with T tube implantation were accomplished in 36 cases, with 20 cases decannulated. Among 10 cases experienced laryngotracheal split, skin graft in laryngotracheal cavity with T tube implantation, 7 decannulated. Among 6 cases of laryngotracheal split, pedicled hyoid flap transfer for reconstruction of the laryngotracheal framework defect, 4 cases decannulated. Tracheal and cricotracheal resection and end-end anastomosis were performed in 9 cases, 7 cases decannulated after single procedure. Two cases of subglottic stenosis with trachoesophageal fistula were repaired with laryngotracheal plasticity in single procedure successfully. Fifty seven patients were decannulated after different procedures with variable hoarseness, within 6 months to 5 years follow-up. Six cases failed in decannulation. The decannulation rate was 90.5%. Conclusions Traumatic laryngotracheal stenosis is a complex problem that usually needs a longer time for reconstruction and a different ways of approaches. It is necessary to evaluate the laryngotracheal framework defect, the degree and extension of stenosis systematically before overation for surgical planning.
