LARYNGO TRACHEAL STENOSIS : MANAGEMENT AND ITS OUTCOMES

Dr.Ishani Patel, Dr.Kalpesh Patel

Abstract


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.


Keywords


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

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References


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