Laryngeal split and rib cartilage interpositional grafting: Treatment option for glottic/subglottic stenosis in adults


Autoria(s): TERRA, Ricardo Mingarini; MINAMOTO, Helio; CARNEIRO, Felipe; PEGO-FERNANDES, Paulo Manuel; JATENE, Fabio Biscegli
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

19/10/2012

19/10/2012

2009

Resumo

Objectives: Severe glottic/subglottic stenosis (complex laryngotracheal stenosis) is a rare but challenging complication of endotracheal intubation. Laryngotracheal reconstruction with cartilage graft and an intralaryngeal stent is a procedure described for complex laryngotracheal stenosis management in children; however, for adults, few options remain. Our aim was to analyze the results of laryngotracheal reconstruction as a treatment for complex laryngotracheal stenosis in adults, considering postoperative and long-term outcome. Methods: Laryngotracheal reconstruction (laryngeal split with anterior and posterior interposition of a rib cartilage graft) has been used in our institution to manage glottic/subglottic stenosis restricted to the larynx; laryngotracheal reconstruction associated with cricotracheal resection has been used to treat glottic/subglottic/upper tracheal stenosis (extending beyond the second tracheal ring). A retrospective study was conducted, including all patients with complex laryngotracheal stenosis treated surgically in our institution from January of 2002 until December of 2005. Results: Twenty patients (10 male and 10 female patients; average age, 36.13 years; age range, 18-54 years) were included. There were no deaths, and the postoperative complications were as follows: dysphonia, 25%; subcutaneous emphysema, 10%; tracheocutaneous fistula, 20%; wound infection, 15%; and bleeding, 5.0%. Eighty percent of the patients were completely decannulated after a mean of 23.4 months of follow-up (range, 4 -55 months). Conclusions: Laryngeal split with anterior and posterior cartilage graft interposition as an isolated procedure or associated with a cricotracheal resection is a feasible and low-morbidity alternative for complex laryngotracheal stenosis treatment.

Identificador

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, v.137, n.4, p.818-823, 2009

0022-5223

http://producao.usp.br/handle/BDPI/23670

10.1016/j.jtcvs.2008.08.035

http://dx.doi.org/10.1016/j.jtcvs.2008.08.035

Idioma(s)

eng

Publicador

MOSBY-ELSEVIER

Relação

Journal of Thoracic and Cardiovascular Surgery

Direitos

restrictedAccess

Copyright MOSBY-ELSEVIER

Palavras-Chave #POSTINTUBATION SUBGLOTTIC STENOSIS #PEDIATRIC AIRWAY STENOSIS #LARYNGOTRACHEAL RECONSTRUCTION #CRICOTRACHEAL RESECTION #CHILDREN #Cardiac & Cardiovascular Systems #Respiratory System #Surgery
Tipo

article

original article

publishedVersion