Summary
Sixty patients with subglottic stenosis of acquired and nonneoplastic origin were
surgically managed by multiple open procedures. Follow-up ranged from 1 to 10 years.
Fifty-seven patients had stable and excellent or good results, 2 of them after further
surgery, 1 patient had to live with a retained tracheostomy indefinitively and the
remaining 2 patients died.
While the whole spectrum of surgical modalities employed in this series may not be
recommended with total conviction, the authors express their satisfaction with single
resection and end-to-end anastomosis which yields invariably good and rapidly obtainable
results (22 cases with complete success). Nevertheless, larnygeal enlargement seems
to be essential in the case of upper glottic lesions (19 operations provided 19 successes)
while primary resection with moulding plasties may be applicable to complex and extended
stenoses (19 operations: 16 successful results and 3 failures).
With regard to the choice of operation, the authors emphasize the importance of careful
preoperative assessment of the lesions which should assure adequate selection of therapeutic
methods according to the degree of associated involvement of the trachea, glottis
or supraglottic area.
Conservative measures including dilatation, electro-coagulation and laser-beam surgery
are considered as palliative only, however, they may be useful either in the course
of the patient's preparation or in order to achieve more successful postoperative
results.
Key words
Larynx - Laryngotracheal stenosis - Respiratory intensive care - Laryngotracheal plasties
