Abstract:Abstract:ObjectiveTo explore the optimal surgical method and analyze its curative effect for tracheal stenosis with different stenotic position, length, degree and plane.MethodsClinical data of 42 patients suffering from laryngotracheal stenosis surgically treated in our department between 2011 and 2015 were analyzed retrospectively. Of them, 23 cases underwent scar excision by CO2 laser under selfrestaining laryngoscope, 10 received scar excision combined with Ttube placement via laryngofissure, 2 were given laryngotracheal reconstruction with sternocleidomastoid myoperiosteal flap and Ttube placement, and 7 were treated with end to end tracheal anastomosis after sleeve resection. All patients had been followed up for 1 to 6 years postoperatively. Clinical data including the number of operations, duration of Ttube placement, function of swallowing and feeding as well as exercise capacity were recorded and analyzed to evaluate the therapeutic effect.ResultsA total of 67 operations were performed to the 42 patients, including 35 CO2 laser excisions, 18 scar excisions combined with Ttube placement via laryngofissure, and 7 laryngotracheal reconstructions with sternocleidomastoid myoperiosteal flap and Ttube placement, as well as 7 end to end tracheal anastomoses after sleeve resection. 24 cases were cured after single operation, 3 cases after 2 operations, 5 cases after 3 operations, 1 case after four operations and 1 case after five operations, while 6 cases respired depending on Ttube permanently and 2 cases died. The success ratio of operation was 80.95%, and the decannulation rate was 66.7%. In addition, hoarseness presented in 38 cases and the exercise capacity decreased in 3.ConclusionsLaryngotracheal stenosis requires individual precise preoperative assessments of stenotic position, length, degree and plane, as well as physical condition of the patient to select the optimal surgical method. Meanwhile, proper adjuvant medical treatment should be supplied for reducing recurrence.
