Summary
The authors describe an open technique that has been used over the past 25 years to reconstruct the subglottic tracheal region in two stages after extensive laryngotracheal stenosis. After submucosal resection of fibrous tissue and reconstruction of the subglottic and tracheal skeleton by means of two autologous osseous grafts, a large laryngotracheostomy is created during the initial stage. Some weeks later, in the second stage, the anterior wall is closed, using two cervical hinge-door flaps. Ten patients have undergone this procedure, with a minimum follow-up of 3 years. All of the patients were decannulated upon completion of the treatment without recurrence of stenosis during the follow-up period.
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References
Alonso WA (1979) Hyoid arch transposition. Otolaryngol Clin North Am 12:903–908
Biller HF, Lawson W (1981) The management of advanced laryngotracheal stenosis. Staged reconstruction. Laryngoscope 91:217–220
Biller HF, Lawson W (1986) Staged repair of extensive tracheal and laryngotracheal stenoses. Ann Otol Rhinol Laryngol 95:586–589
Bone RC (1979) Subglottic stenosis. Otolaryngol Clin North Am 12:869–875
Catlin F, Smith R (1987) Acquired subglottic stenosis in children. Ann Otol Rhinol Laryngol 5:448–492
Cotton RT (1984) Management of combined advanced and subglottic stenosis in infancy and childhood. Laryngoscope 91:221–225
Deboer JU, Shaffer K (1979) The radiology of laryngeal and tracheal stenosis. Otolaryngol Clin North Am 12:783–796
Eliachar I, Marovitch A, Har Shai Y (1984) Rotatory door flap in laryngotracheal reconstruction. Arch Otolaryngol 110:585–590
Evans JNG, Todd GB (1974) Laryngotracheoplasty. J Laryngol Otol 88:589–597
Fairchild FR (1927) Reconstruction of the trachea. Surg Gynecol Obstet 44:119–122
Friedman M, Grybauskas V (1986) Reconstruction of the subglottic larynx with a myoperiostal flap. Clinical and experimental study. Head Neck Surg 1986:287–295
Goode R, Shinn J (1977) Long-term stenting in the treatment of subglottic stenosis. Ann Otol Rhinol Laryngol 86:795–798
Gray S, Miller R, Myer CH, Cotton R (1987) Adjunctive measures for successful laryngotracheal reconstruction. Ann Otol Rhinol Laryngol 5:509–514
Grillo H (1982) Reconstructive techniques for extensive postintubation tracheal stenosis. Int Surg 67:215–220
Grundfast K, Morris M, Bernsley C (1987) Subglottic stenosis: retrospective analysis and proposal for standard reporting system. Ann Otol Rhinol Laryngol 96:101–105
Hagenauer JP (1982) Evolution des idées sur le traitement des stenoses laryngo-tracheales cicatricielles. J Fr Oto-RhinoLaryngol 31:419–422
Hollinger LD (1982) Treatment of severe subglottic stenosis without tracheotomy. A preliminary report. Ann Otol Rhinol Laryngol 91:407–412
Kenan P (1972) Complications associated with tracheostomy: prevention and treatment. Otolaryngol Clin North Am 12: 807–816
Laccoureye H, Beutter P (1981) Les stenoses laryryngées et laryngotrachéales. Ann Otolaryngol (Paris) 98:571–579
Lawson W, Som M (1977) Delayed tracheal reconstruction. Trans Am Acad Ophthalmol Otolaryngo l84:139–144
Maniglia AJ (1979) Tracheal stenosis: conservative surgery as a primary mode of management. Otolaryngol Clin North Am 12:877–892
Maran AGD (1979) Trauma and stenosis of the larynx. In: Stell P, Maran AGD (eds) Clinical otolaryngology. Buttersworth, London, pp 144–154
Marquet J (1965) Un cas de sténose cicatricielle du larynx. Rev Laryngol Rhinol Otol (Bord) 1:134–136
Montgommery WW (1982) Subglottic stenosis. Int Surg 67: 199–207
Pech A, Cannoni M, Adul S (1978) Le traitement des stenoses sous-glotto-tracheales. J Fr Oto-Rhino-Laryngol 27:457–463
Ross J (1979) Techniques in the surgical repair of tracheal stenosis. Otolaryngol Clin North Am 12:893–899
Shapshay S, Bearnis J (1987) Endoscopic treatment of subglottic and tracheal stenosis by radial laser incision and dilatation. Ann Otol Rhinol Laryngol 96: 661–665
Steensen SH (1982) Repair of a subglottic stenosis by submucosal resection. J Laryngol Otol 96:469–471
Stell PM, Maran AGD (1985) Chronic laryngeal stenosis. Ann Otol Rhinol Laryngol 94:108–113
Strome M (1984) Subglottic stenosis: therapeutic considerations. Otolaryngol Clin North Am 17:63–68
Strong MS, Healy GB, Vaughan CH, Fried MP (1979) Endoscopic management of laryngeal stenosis. Otolaryngol Clin North Am 12:797–805
Thawley SE, Ogura JH (1981) Use of the thyroid graft for the treatment of laryngo-tracheal stenosis. Laryngoscope 91:226–232
Toohill RJ (1979) Autogenous graft reconstruction of the larynx and upper trachea. Otolaryngol Clin North Am 12: 903–908
Ward P, Canalis R (1977) Composite hyoid sternohyoid muscle grafts in humans. Arch Otolaryngol 103:531–534
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Somers, T., Marquet, S. & Offeciers, E. Two-stage repair of extensive subglottic tracheal stenosis. Eur Arch Otorhinolaryngol 248, 82–86 (1990). https://doi.org/10.1007/BF00240225
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DOI: https://doi.org/10.1007/BF00240225