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End-to-end anastomosis in the management of laryngotracheal defects

Published online by Cambridge University Press:  13 March 2017

E D Gozen ,
M Yener ,
Z B Erdur  and
E Karaman
E D Gozen
Affiliation:
Otorhinolaryngology Department, Cerrahpasa Medical Faculty, Istanbul University, Turkey
M Yener
Affiliation:
Otorhinolaryngology Department, Cerrahpasa Medical Faculty, Istanbul University, Turkey
Z B Erdur
Affiliation:
Otorhinolaryngology Department, Cerrahpasa Medical Faculty, Istanbul University, Turkey
E Karaman*
Affiliation:
Otorhinolaryngology Department, Cerrahpasa Medical Faculty, Istanbul University, Turkey
*
Address for correspondence: Dr Emin Karaman, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, KBB ABD, Cerrahpasa, Fatih, 34098, İstanbul, Turkey E-mail: [email protected]
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Abstract

Objective:

To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection.

Methods:

A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis.

Results:

Length of stenosis was 1.7–4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n = 4), cricotracheal anastomosis (n = 2) and thyrotracheal anastomosis (n = 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n = 1), subcutaneous emphysema (n = 1), temporary unilateral vocal fold palsy (n = 1), granulation tissue development (n = 1), and restenosis (n = 2).

Conclusion:

End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.

Keywords

Airway ObstructionTracheal StenosisAcquired Subglottic Stenosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 5 , May 2017 , pp. 447 - 454
Copyright
Copyright © JLO (1984) Limited 2017 

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