Single-stage surgical repair of benign laryngotracheal stenosis in adults

Background. Benign laryngotracheal stenosis causes considerable morbidity. In a retrospective study, we describe the results of our surgical treatment. Methods. Between June 1999 and June 2002, 14 adults with laryngotracheal stenosis were referred to our hospital. Stenosis resulted from mechanical ventilation in 11 patients, from Wegener's granulomatosis in 2 patients, and from strangulation in 1 patient. Eleven patients had a tracheotomy. One patient was found unfit for surgery. Nine patients underwent cricotracheal resection (CTR) with end-to-end anastomosis, and four patients underwent single-stage laryngotracheoplasty (SS-LTP) without stenting. Results. There were no perioperative deaths. Patients were extubated after mean of 3 days (range, 0-10 days; CTR 2.3 days vs SS-LTP 3.5 days, p = .45). There were in-hospital complications in five patients. Mean hospital stay was 19 days (range, 8-53 days; after CTR 24 days vs SS-LTP 9 days, p = .015). With regard to airway patency and voice recovery, 10 patients (77%) had good results, including 1 patient with two readmissions, and 3 (23%) had satisfactory results, including 1 patient with 11 additional nonsurgical interventions. Conclusions. Benign laryngotracheal stenosis in the adult patient can be repaired successfully using a strategy of two single-stage surgical procedures. All patients had good or satisfactory functional results. A multidisciplinary approach was essential to achieve these good results. (C) 2004 Wiley Periodicals, Inc.