Successful Treatment of Idiopathic Laryngotracheal Stenosis by Resection and Primary Anastomosis

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Abstract

We studied the early and long-term response of idiopathic laryngotracheal stenosis (ILTS) to treatment by 1-stage laryngotracheal or tracheal resection and reconstruction in 73 patients. Nineteen of the 72 (26%) noted no difference in their voices or any difficulty in breathing after reconstruction. Forty-seven (64%) described loss of ability to project their voices as loudly as before or noted some difficulty in singing as well as they did before. Five (7%) had various degrees of dyspnea or stridor on effort. One needed continued dilation. The median follow-up was 8 years. Surgical treatment gave good or excellent results in 90% of these patients with ILTS. Recurrence or progression of stenosis was not evident.

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Idiopathic progressive subglottic stenosis: findings and treatment in 52 patients.

H Dedo, M Catten (2001)

Rarely, patients develop severe idiopathic subglottic stenosis. In 34 years, we have observed this disorder in 52 patients. All but 1 of the patients were female--a finding that suggests a hormonal cause. Without treatment, the airway progressively narrows--in some cases, until the patient requires tracheotomy. Laser submucosal resection and rotation mucosal flaps open and stabilize the airway and provide effective palliation. However, unlike traumatic subglottic stenosis, which has been cured with this technique, the idiopathic form causes submucosal fibrosis that regenerates spontaneously. Thus, treatment helps, but does not cure, the patient. The characteristic pathological finding is of submucosal dense fibrotic tissue with evidence of chronic inflammation. The clinical findings and treatment are here discussed.

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Idiopathic laryngotracheal stenosis and its management.

H Grillo, E J Mark, D J Mathisen … (1993)

We describe idiopathic laryngotracheal and upper tracheal stenosis in 49 patients with no other cause for their stenosis. Traumatic, iatrogenic, infectious, and specific inflammatory processes were excluded. Histopathologically dense fibrosis of keloidal type thickened the lamina propria and choked the ducts of mucous glands but did not destroy cartilage. Thirty-five patients were treated by single-stage resection and reconstruction: 29 by laryngotracheal resection with laryngotracheoplasty and 6 by cricotracheal segmental resection. Thirty-two patients achieved good or excellent results in respiration and voice, 2 needed annual dilations, and 1 required permanent tracheostomy.

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Gastroesophageal reflux in patients with subglottic stenosis.

M Gerber, D L Walner, Y Stern … (1998)

To determine the incidence of gastroesophageal reflux in patients with subglottic stenosis (SGS) and to determine if upper esophageal reflux occurs in addition to lower esophageal reflux in these patients.