Surgical treatment of benign laryngotracheal stenosis: IPO de Lisboa 20-year experience

Authors

  • Marisa Rosário Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de Lisboa Central, Portugal
  • António Nicolau Fernandes Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Daniel Cabral Serviço de Cirurgia Torácica do Centro Hospitalar Universitário de Lisboa Norte, Portugal
  • Joana Marques Serviço de Otorrinolaringologia do Centro Hospitalar de São João, Portugal
  • Inês Delgado Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Ana Hebe Serviço de Otorrinolaringologia do Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal
  • Pedro Montalvão Serviço de Otorrinolaringologia do Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal
  • Miguel Magalhães Serviço de Otorrinolaringologia do Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal

DOI:

https://doi.org/10.34631/sporl.971

Keywords:

laryngotracheal stenosis, treatment, surgical repair, orotracheal intubation, tracheomalacia, tracheotomy

Abstract

There is a wide range of therapeutic approaches to laryngotracheal stenosis (LTS).

In this study, all the patients that underwent LTS surgical correction in the ENT department of IPO Lisboa between 2000 and 2020 were identified. Variable studied included patient demographics, etiology of the laryngotracheal pathology, LTS location, previous procedures, type of procedure, post-surgical results and complications and follow-up duration.

From 53 patients that were included, mean age 50 years and identical gender distribution, 49,1% have had previous oro-tracheal intubation. First surgery was realized by an external approach in 77,4% of the patients. Restenosis occurred in 47,3% of the studied cases, with a mean of 2,6 surgeries. 32,1% of the patients remain tracheotomy dependent. Tracheomalacia was associated with the impossibility to achieve decannulation (p<0.001).

LTS therapeutic approach frequently requires multiple surgeries. Tracheomalacia prevention can contribute to reduce LTS incidence.

References

Myer CMI, O’Connor DM, Cotton RT. Proposed Grading System for Subglottic Stenosis Based on Endotracheal Tube Sizes. Annals of Otol Rhinol Laryngol. 1994;103(4):309–23.

Gallo A, Pagliuca G, Greco A, Martellucci S, Mascelli A, Fusconi M, et al. Laryngotracheal stenosis treated with multiple surgeries: experience, results and prognostic factors in 70 patients. Acta Otorrhinolaryngologica Italica. 2012;32:182–8.

Spector G. Developmental anatomy of the larynx. In: Ballenger J, editor. Diseases of the Ear, Nose, and Throat. Philadelphia; 1984.

Courey M. Airway obstruction. The problem and its causes. Otolaryngol Clin North Am. 1995;4:673–84.

Peña J, Cicero R, Marín J, Ramírez M, Cruz S, Navarro F. Laryngotracheal reconstruction in subglottic stenosis: An ancient problem still present. Otolaryngology - Head and Neck Surgery. 2001;125(4):397–400.

R Core Team. R: A language and environment for statistical computing [Internet]. Vienna, Austria; 2021. Available from: https:// www.R-project.org/

Medicode (firm). ICD-9-CM: International classification of diseases, 9th revision, clinical modification. Salt Lake City, Utah: Medicode; 1996.

Nikolovski N, Kopacheva-Barsova G, Pejkovska A. Laryngotracheal stenosis: A retrospective analysis of their aetiology, diagnose and treatment. Open Access Macedonian Journal of Medical Sciences. 2019 May 15;7(10):1649–56.

Smith MM, Cotton RT. Diagnosis and management of laryngotracheal stenosis. Vol. 12, Expert Review of Respiratory Medicine. Taylor and Francis Ltd.; 2018. p. 709–17.

McCaffrey T v. Classification of laryngotracheal stenosis. Laryngoscope. 1992;102(12 Pt1):1335–40.

Gadkaree SK, Pandian V, Best S, Motz KM, Allen C, Kim Y, et al. Laryngotracheal Stenosis: Risk Factors for Tracheostomy Dependence and Dilation Interval. Otolaryngology - Head and Neck Surgery (United States). 2017 Feb 1;156(2):321–8.

Woliansky J, Paddle P, Phyland D. Laryngotracheal Stenosis Management: A 16-Year Experience. Ear, Nose and Throat Journal. 2021 Jun 1;100(5):360–7.

Lewis S, Earley M, Rosenfeld R, Silverman J. Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis. Vol. 127, Laryngoscope. John Wiley and Sons Inc.; 2017. p. 191–8.

Maurizi G, Vanni C, Rendina EA, Ciccone AM, Ibrahim M, Andreetti C, et al. Surgery for laryngotracheal stenosis: Improved results. In: Journal of Thoracic and Cardiovascular Surgery. Mosby Inc.; 2021. p. 845–52.

Bitar MA, al Barazi R, Barakeh R. Reconstrução de via aérea: revisão de uma abordagem à estenose laringotraqueal em estágio avançado. Brazilian Journal of Otorhinolaryngology. 2017 May 1;83(3):299–312.

Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J. Causes and consequences of adult laryngotracheal stenosis. Laryngoscope. 2015 May 1;125(5):1137–43.

Downloads

Published

2022-06-07

How to Cite

Rosário, M., Fernandes, A. N., Cabral, D., Marques, J., Delgado, I., Hebe, A., Montalvão, P., & Magalhães, M. (2022). Surgical treatment of benign laryngotracheal stenosis: IPO de Lisboa 20-year experience. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 60(2), 89–94. https://doi.org/10.34631/sporl.971

Issue

Vol. 60 No. 2 (2022): June

Section

Original Article

License

Copyright (c) 2022 Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.