Dr.Ishani Patel, Dr.Kalpesh Patel


TIntroduction: Laryngotracheal stenosis (LTS) implies a partial or complete narrowing of the larynx and/or trachea. Surgical management of it is technically challenging due to complex anatomy and delicate nature of airway structures. Ourstudy aims to study clinical profile, management, and surgical outcome of LTS. Materials and Methods: All patients with LTS treated between 2015 and 2018 were included in in our study.They underwent endoscopic assessment followed by definitive management which included endoscopic and external surgical techniques. The success of treatment was defined by decannulation Subjective assessment of voice quality.Results: A total of 30 patients with benign LTS were treated. Prolonged intubation was the single largest cause (56%). subglottic stenosis formed the largest group (74%) followed by Tracheal stenosis (14%).patiens were devided in four group depending upon surgical procedure they underwent:GROUP-I,endoscopic laser excision and dilatation(12cases),GROUP-II laryngo tracheoplasty and t-tube insertion(10 cases),GRUP-III tracheal stent insertion(3 cases),GROUPIV-Rection and anstomosis.Rate of decannalation following this surgical procedure in GROUP-I,GROUP-II,GROUP-III and GROUP-IV were 58%,60%,33% and80%.A total of  19 patients (63%) have been successfully decannulated. Conclusions: The use of appropriate size, low pressure cuffed tubes, and early tracheostomy will help in preventing LTS. The precise assessment of laryngotracheal complex is most useful in planning of management. Choice of treatment depends on location, severity, and length of stenosis, as well as on patient comorbidities an dhistory of previous interventions. Goal of our treatment modality is to achieve a patent airway and acceptable voice quality.


Endoscopic management, laryngotracheal reconstruction, laryngotracheal stenosis, t-tube, partial cricotracheal resection,end to end anastomosis.

Full Text:



Grillo HC, Donahue DM, Mathisen DJ, Wain JC, WrightCD.Postintubation tracheal stenosis. Treatment andresults. J ThoracCardiovasc Surg 1995;109:486‑92.

Sarper A, Ayten A, Eser I, Ozbudak O, Demircan A. Tracheal stenosis aftertracheostomy or intubation: Review with special regard to cause and management. Tex Heart Inst J 2005;32:154‑8.

Massoud EA, McCullough DW. Adult‑acquired laryngeal stenosis:A study of prognostic factors. J Otolaryngol 1995;24:234‑7.

Mathias DB, Wedley JR. The effects of cuffed endotracheal tubeson the tracheal wall. Br J Anaesth 1974;46:849‑52.

Spittle CS, Beavis SE. Post‑intubation tracheal stenosis. Hosp Med2001;62:54.

Ahmad I, Pahor AL. Post‑intubation tracheal stenosis. Hosp Med2000;61:508‑9.

Cherian TA, Rupa V, Raman R. External laryngeal trauma: Analysis of thirty cases. J Laryngol Otol 1993;107:920‑3.

Yen PT, Lee HY, Tsai MH, Chan ST, Huang TS. Clinical analysis of external laryngeal trauma. J Laryngol Otol 1994;108:221‑5.

Gallo A, Pagliuca G, Greco A, Martellucci S, Mascelli A,usconi M, et al. Laryngotracheal stenosis treated with multiple surgeries: Experience, results and prognostic factors in 70 patients. Acta OtorhinolaryngolItal2012;32:182‑8.

Monnier P, George M, Monod ML, Lang F. The role of the CO2laser in the management of laryngotracheal stenosis: A survey of100 cases. Eur Arch Otorhinolaryngol 2005;262:602‑8.

Oh SK, Park KN, Lee SW. Long‑term results of endoscopic dilatation for tracheal and subglottic stenosis. Clin Exp Otorhinolaryngol2014;7:324‑8.

Perepelitsyn I, Shapshay SM. Endoscopic treatment of laryngealand tracheal stenosis‑has mitomycin C improved the outcome?Otolaryngol Head Neck Surg 2004;131:16‑20.

Simpson CB, James JC. The efficacy of mitomycin‑C in the treatment of laryngotracheal stenosis. Laryngoscope 2006;116:1923‑5.

Liew YT, Yong DJ, Somasundran M, Lum CL. Managementexperience of subglottic stenosis by endoscopic bougie dilatationwith mitomycin C and review of literature: Case series. Indian JOtolaryngol Head Neck Surg 2015;67:129‑33.

George M, Lang F, Pasche P, Monnier P. Surgical managementof laryngotracheal stenosis in adults. Eur Arch Otorhinolaryngol2005;262:609‑15.

Marques P, Leal L, Spratley J, Cardoso E, Santos M. Trachealresection with primary anastomosis: 10 years experience. Am JOtolaryngol 2009;30:415‑8.

Hassan FH, Goh BS, Kong MH, Marina MB, Sani A. Trachealresection and anastomosis: An 11 year management outcome.Rawal Med J 2013;38:177-80.

Pearson FG, Cooper JD, Nelems JM, Van Nostrand AW. Primarytracheal anastomosis after resection of the cricoid cartilage withpreservation of recurrent laryngeal nerves. J Thorac Cardiovasc

Surg 1975;70:806‑16.

Montgomery WW. Suprahyoid release for tracheal anastomosis.Arch Otolaryngol 1974;99:255‑60.

.Dedo HH, Fishman NH. Laryngeal release and sleeve resection for tracheal stenosis. Ann Otol Rhinol Laryngol 1969;78:285‑96.

Kato I, Iwatake H, Tsutsumi K, Koizuka I, Suzuki H, Nakamura T, et al. End‑to‑end anastomosis in chronic tracheal stenosis. AurisNasus Larynx 2003;30 Suppl:S69.


  • There are currently no refbacks.