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Ann Thorac Surg 1995;60:259-260
© 1995 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 250.

DR F. GRIFFITH PEARSON (Toronto, Ont, Canada): Doctor Couraud, I congratulate you on a clear presentation of a very important experience. I have known Dr Couraud since he organized an international meeting in his hometown of Bordeaux in 1981. That meeting was the first combined meeting of thoracic surgeons and otolaryngologists that I ever attended. As you see from Dr Couraud's presentation, he has been working for a long time in an area in which few thoracic surgeons have experience. I visited Dr Couraud in Bordeaux and know that he is a pragmatic, experienced clinician and an extremely skilled technical surgeon, and his observations are critical and original. He learns from his own observations, and has made some very original contributions, which have been presented here today. He also has carefully followed up these patients. Endoscopic follow-up was done early, and then again at 1 year and at 3 years, so this is a well-documented experience.

He emphasizes the principles for success: These are (1) waiting until all the inflammatory process has subsided, (2) removal of all of the chronically, irreversibly damaged airway, (3) preserving circulation, (4) careful mucosal apposition, and (5) minimizing tension. The results speak for themselves, and are outstanding.

Some of the very original contributions in this work are those cases where the larynx is damaged or destroyed. I first heard Dr Couraud's report of some of these cases 5 or 6 years ago. Where the entire cricoid was lost, (it was a sequestrum I think at operation), he has sewn the distal trachea . . . [Full Text of this Article]

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Surgical Treatment of Nontumoral Stenoses of the Upper Airway

Louis Couraud, Jacques B. Jougon, and Jean-François Velly
Ann. Thorac. Surg. 1995 60: 250-259. [Abstract] [Full Text]