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Treatment of idiopathic laryngotracheal stenosis with laryngotracheal reconstruction

Published online by Cambridge University Press:  19 August 2009

P Cui  and
W Chen
P Cui*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
W Chen
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
*
Address for correspondence: Dr Pengcheng Cui, Department of Otolaryngology-Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, PR China. Fax: 86 29 84777446 E-mail: cuipc@fmmu.edu.cn
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Abstract

Objectives:

We evaluated the efficacy of laryngotracheal reconstruction with costal cartilage grafting for the treatment of idiopathic laryngotracheal stenosis.

Methods:

From January 2001 to December 2005, 129 patients with laryngotracheal stenosis were treated at our hospital. Of these patients, five (4 per cent) female patients whose ages ranged from 14 to 34 years were identified as having idiopathic laryngotracheal stenosis. These patients were treated with a modified laryngotracheal reconstruction with anterior costal cartilage grafting. A Montgomery T-tube remained in place for 12 to 22 months.

Results:

Three patients presented with grade three and two with grade two stenosis. Three patients were decannulated after one procedure, with normal respiratory function and good exercise tolerance; one patient was decannulated after two procedures. One patient failed decannulation. The mean time to decannulation was 13 months.

Conclusions:

Laryngotracheal reconstruction with anterior costal cartilage grafting is a safe and effective method, and provides an alternative treatment for idiopathic laryngotracheal stenosis.

Keywords

LarynxTracheaStenosisReconstructive Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1233 - 1236
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Benjamin, B, Jacobson, I, Eckstein, R. Idiopathic subglottic stenosis: diagnosis and endoscopic laser treatment. Ann Otol Rhinol Laryngol 1997;106:770–4CrossRefGoogle ScholarPubMed
2Ashiku, SK, Mathisen, DJ. Idiopathic laryngotracheal stenosis. Chest Surg Clin North Am 2003;13:257–69Google Scholar
3Dedo, HH, Catten, MD. Idiopathic progressive subglottic stenosis: findings and treatment in 52 patients. Ann Otol Rhinol Laryngol 2001;110:305–11Google Scholar
4Valdez, TA, Shapshay, SM. Idiopathic subglottic stenosis revisited. Ann Otol Rhinol Laryngol 2002;111:690–5CrossRefGoogle ScholarPubMed
5Grillo, HC, Mark, EJ, Mathisen, DJ, Wain, JC. Idiopathic laryngotracheal stenosis and its management. Ann Thorac Surg 1993;56:80–7CrossRefGoogle ScholarPubMed
6Ashiku, SK, Kuzucu, A, Grillo, HC, Wright, CD, Wain, JC, Lo, B et al. Idiopathic laryngotracheal stenosis: effective definitive treatment with laryngotracheal resection. J Thorac Cardiovasc Surg 2004;127:99–107CrossRefGoogle ScholarPubMed
7Myer, CM 3rd, O'Connor, DM, Cotton, RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103:319–23CrossRefGoogle ScholarPubMed
8Cotton, R. Management of subglottic stenosis in infancy and childhood. Review of a consecutive series of cases managed by surgical reconstruction. Ann Otol Rhinol Laryngol 1978;87:649–57Google Scholar
9Zalzal, GH, Cotton, R. A new way of carving cartilage grafts to avoid prolapse into the tracheal lumen when used in subglottic reconstruction. Laryngoscope 1986;96:1039Google Scholar
10Jindal, JR, Milbrath, MM, Shaker, R, Hogan, WJ, Toohill, RJ. Gastroesophageal reflux disease as a likely cause of “idiopathic” subglottic stenosis. Ann Otol Rhinol Laryngol 1994;103:186–91CrossRefGoogle ScholarPubMed
11Grillo, HC, Mathisen, DJ, Ashiku, SK, Wright, CD, Wain, JC. Successful treatment of idiopathic laryngotracheal stenosis by resection and primary anastomosis. Ann Otol Rhinol Laryngol 2003;112:798–800Google Scholar
12Giudice, M, Piazza, C, Foccoli, P, Toninelli, C, Cavaliere, S, Peretti, G. Idiopathic subglottic stenosis: management by endoscopic and open-neck surgery in a series of 30 patients. Eur Arch Otorhinolaryngol 2003;260:235–8CrossRefGoogle Scholar
13Lee, KH, Rutter, MJ. Role of balloon dilation in the management of adult idiopathic subglottic stenosis. Ann Otol Rhinol Laryngol 2008;117:81–4CrossRefGoogle ScholarPubMed
14Rethi, A. An operation for cicatricial stenosis of the larynx. J Laryngol Otol 1956;70:283–93Google Scholar
15Stern, Y, Willging, JP, Cotton, RT. Use of Montgomery T-tube in laryngotracheal reconstruction in children: is it safe? Ann Otol Rhinol Laryngol 1998;107:1006–9Google Scholar