Artikel
Fifteen years experience with the cricotracheal segment resection
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Autoren
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Jenő Czigner
- ENT and Head and Neck Surg. Dept. of Univ. of Szeged, Ungarn
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László Rovó
- ENT and Head and Neck Surg. Dept. of Univ. of Szeged, Ungarn
| Veröffentlicht: | 22. September 2005 |
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Gliederung
Text
The traditional approach to surgical reconstruction of the laryngotracheal stenosis is laryngofissure for the laryngeal component and staged plastic reconstruction of the cricotracheal stenosis. Reported results are variable and unpredictable, and permanent decanulation is impossible in significant number of patients.
Authors report experience with 33 patients with combined subglottic and tracheal stenosis who were managed by a two stages operation procedure: a preoperative endoscopic laser scar vaporization to prevent the patients from the urgent tracheotomy, and later an elective cricotracheal segment resection with a primary end to end anastomosis as the definitive surgical treatment.
Type of anastomosis was tracheo-thyreopexy in six, tracheo-cricopexy in sixteen, tracheo-tracheopexy in eleven cases. The average length of the resected segments was 3,5 cm (range: 2-7,5 cm). Adequate airway with excellent quality of life was achieved in 30 patients during the minimum one year follow up period. One 40% and two 50 % restenosis have been found in the remaining 3 cases. There was a sever MRSA wound infection among these latter patients, but there were no other major complication or compromise in swallowing and voicing.
The approach described for these cricotracheal stenoses provides better results than those reported traditional staged and plastic techniques of reconstructions
