Management of laryngotracheal stenosis (LTS) remains one of the most challenging problems facing the otolaryngologist. The key to success is to obtain adequate rigid circular support with normal mucosal lining. Sixty patients with LTS were surgically treated in our institution over a 20-year period. Most patients were adults; the mean age was 29 years. There were 39 males and 21 females. The most frequent cause of stenosis was intubation, in 25 patients, and tracheostomy was the cause in 21. Forty-two patients (70%) were successfully decannulated following 117 procedures in this series. An average of 1.95 procedures per patient was performed. The median time between treatment and decannulation was 561 days. These results confirm the complexity of the management of LTS. Decannulation is not always possible, and to achieve this goal, more than one treatment is frequently required. It is better to prevent LTS rather than to treat it once it has occurred.
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http://dx.doi.org/10.1177/000348949810700708 | 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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