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Ann Thorac Surg 1992;53:54-63
© 1992 The Society of Thoracic Surgeons

Articles

Laryngotracheal resection and reconstruction for subglottic stenosis

Hermes C. Grillo, MD*, Douglas J. Mathisen, MD, John C. Wain, MD

General Thoracic Surgical Unit. Massachusetts General Hospital, and Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA

* Address reprint requests to Dr Grillo, Massachusetts General Hospital, Boston, MA 02114.

Eighty patients with inflammatory stenoses of the subglottic larynx and upper trachea were treated by singlestage laryngotracheal resection and reconstruction. Fifty stenoses originated from postintubation lesions (endotracheal tubes, tracheostomy, cricothyroidostomy), 7 originated from trauma, 19 were idiopathic, and 4 were miscellaneous. Repair consisted of resection of the anterolateral cricoid arch in all patients, plus resection of posterior laryngeal stenosis where present, with salvage of the posterior cricoid plate, appropriate resection and tailoring of the trachea, and primary anastomosis using a posterior membranous tracheal wall flap to resurface the bared cricoid cartilage in 31 patients. One postoperative death resulted from acute myocardial infarction. Longterm results were excellent in 18 patients, good in 48, satisfactory in 8, and failute in 2. Three additional patients had good results at discharge but were followed up for less than 6 months.




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