Laryngotracheal trauma can be an immediately life-threatening injury. Failure to recognize such injuries and promptly secure an airway may have fatal consequences. Failure to recognize acute injuries or to observe the principles of management can lead to laryngotracheal stenosis. We have seen 10 patients with acute injuries. Blunt trauma was responsible in 5, penetrating trauma in 4, and iatrogenic injury in 1. Esophageal transection was present in 1 patient. Thoracotomy was required in 2 patients with injury of the carina, and cervical exposure was adequate in 8. All patients underwent successful repair of the injuries. Seventeen patients have been treated for delayed traumatic laryngotracheal stenosis. Vocal cord paralysis was apparent in 14. Concomitant esophageal injury was repaired in 4 patients. Eight patients required intralaryngeal procedures prior to repair of the laryngotracheal stenosis. All patients except 1 have a good airway, and 16 of the 17 have a good voice.
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http://dx.doi.org/10.1016/s0003-4975(10)60608-x | DOI Listing |
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Laryngoscope Investig Otolaryngol
December 2024
National Engineering Research Center of Light Alloy Net Forming, State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering Shanghai Jiao Tong University Shanghai China.
Objective: To develop a reproducible survival rabbit model for laryngotracheal stenosis (LTS).
Methods: Seventy New Zealand white (NZW) rabbits were randomly divided into experimental groups ( = 30) and a control group ( = 40). In experimental groups, a nylon brush was inserted retrograde from the tracheotomy through the subglottis and rotated until a full layer circumferential mucosal injury to cartilage exposure, assisted by fiberoptic laryngoscopy (FOL) visualization.
Cureus
November 2024
Otolaryngology - Head and Neck Surgery, King Saud University Medical City, Riyadh, SAU.
Subglottic and posterior glottic stenosis (PGS) narrows distinct areas of the larynx, while bilateral vocal fold immobility (BVFI) is characterized by static cords. Treatments include open surgeries and newer endoscopic methods, offering comparable safety, quicker recovery, and fewer complications. This study assesses the decannulation rate of endoscopic posterior cricoid split with posterior cartilage grafting (EPCCG) in pediatric patients with posterior glottic stenosis, subglottic stenosis (SGS), and BVFI.
View Article and Find Full Text PDFEur J Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Sant'Andrea Hospital-Sapienza University, Rome, Italy.
Objectives: Idiopathic subglottic stenosis (ISS) is an airway stricture between larynx and trachea, within 1 cm from the vocal cords. Resection-reconstruction present technical issues because of the need to resect the anterior portion of the cricoid cartilage, but not the posterior plate beyond which the recurrent laryngeal nerves access the vocal cords. The main surgical challenge consists of the minute airway calibre short below the cords, ensuing after the resection.
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