Modern management of laryngotracheal stenosis

Heather C. Herrington, Stephen M. Weber, Peter Andersen

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

OBJECTIVES: Laryngotracheal stenosis is a complex problem resulting most often from intubation, trauma,or autoimmune disease. Management options include dilation or airway reconstruction including laryngotracheoplasty (LTP), cricotracheal resection (CTR), and tracheal resection (TR). We describe our experience with management of this difficult problem. STUDY DESIGN: Retrospective chart review of patients treated for laryngotracheal stenosis between January 1995 and July 2005 at an academic, tertiary referral center. METHODS: A total of 127 patients were treated during the study period. Patients were followed, and hospital records were reviewed. RESULTS: There were 38 male and 89 female patients with an average age of 55.5 years treated for laryngotracheal stenosis resulting from intubation (64), idiopathic (25) or autoimmune disease (18), radiation (9), trauma (5), prior surgery (4), and relapsing polychondritis (2). Thirty-three percent were treated for grade I stenosis, 44% grade II, 19% grade III, and 4% grade IV. Seventy percent of patients undergoing initial dilation required a subsequent procedure. LTP, CTR, or TR was performed in 43%, 48%, 71%, and 100% of patients with grade I through IV stenosis, respectively. Among 76 patients undergoing LTP, CTR, or TR, 24 (32%) required a subsequent intervention. Among 36 patients treated with primary LTP, CTR, or TR, only 10 (28%) required further therapy. Twenty-two of 35 (63%) tracheostomy-dependent patients were ultimately decannulated. Three patients died in the immediate postoperative period. CONCLUSIONS: Patients undergoing dilation for laryngotracheal stenosis require multiple procedures. However, major reconstructive procedures are well tolerated and currently represent a viable primary treatment for laryngotracheal stenosis.

Original languageEnglish (US)
Pages (from-to)1553-1557
Number of pages5
JournalLaryngoscope
Volume116
Issue number9
DOIs
StatePublished - Sep 2006

Fingerprint

Pathologic Constriction
Dilatation
Intubation
Autoimmune Diseases
Relapsing Polychondritis
Hospital Records
Tracheostomy
Wounds and Injuries
Postoperative Period
Tertiary Care Centers
Radiation
Therapeutics

Keywords

  • Airway
  • Cricotracheal resection
  • Dilation
  • Intubation
  • Laryngotracheal stenosis
  • Laryngotracheoplasty
  • Tracheal resection
  • Trauma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Modern management of laryngotracheal stenosis. / Herrington, Heather C.; Weber, Stephen M.; Andersen, Peter.

In: Laryngoscope, Vol. 116, No. 9, 09.2006, p. 1553-1557.

Research output: Contribution to journalArticle

Herrington, Heather C. ; Weber, Stephen M. ; Andersen, Peter. / Modern management of laryngotracheal stenosis. In: Laryngoscope. 2006 ; Vol. 116, No. 9. pp. 1553-1557.
@article{01cb5c2001614c9387bde339c23054fc,
title = "Modern management of laryngotracheal stenosis",
abstract = "OBJECTIVES: Laryngotracheal stenosis is a complex problem resulting most often from intubation, trauma,or autoimmune disease. Management options include dilation or airway reconstruction including laryngotracheoplasty (LTP), cricotracheal resection (CTR), and tracheal resection (TR). We describe our experience with management of this difficult problem. STUDY DESIGN: Retrospective chart review of patients treated for laryngotracheal stenosis between January 1995 and July 2005 at an academic, tertiary referral center. METHODS: A total of 127 patients were treated during the study period. Patients were followed, and hospital records were reviewed. RESULTS: There were 38 male and 89 female patients with an average age of 55.5 years treated for laryngotracheal stenosis resulting from intubation (64), idiopathic (25) or autoimmune disease (18), radiation (9), trauma (5), prior surgery (4), and relapsing polychondritis (2). Thirty-three percent were treated for grade I stenosis, 44{\%} grade II, 19{\%} grade III, and 4{\%} grade IV. Seventy percent of patients undergoing initial dilation required a subsequent procedure. LTP, CTR, or TR was performed in 43{\%}, 48{\%}, 71{\%}, and 100{\%} of patients with grade I through IV stenosis, respectively. Among 76 patients undergoing LTP, CTR, or TR, 24 (32{\%}) required a subsequent intervention. Among 36 patients treated with primary LTP, CTR, or TR, only 10 (28{\%}) required further therapy. Twenty-two of 35 (63{\%}) tracheostomy-dependent patients were ultimately decannulated. Three patients died in the immediate postoperative period. CONCLUSIONS: Patients undergoing dilation for laryngotracheal stenosis require multiple procedures. However, major reconstructive procedures are well tolerated and currently represent a viable primary treatment for laryngotracheal stenosis.",
keywords = "Airway, Cricotracheal resection, Dilation, Intubation, Laryngotracheal stenosis, Laryngotracheoplasty, Tracheal resection, Trauma",
author = "Herrington, {Heather C.} and Weber, {Stephen M.} and Peter Andersen",
year = "2006",
month = "9",
doi = "10.1097/01.mlg.0000228006.21941.12",
language = "English (US)",
volume = "116",
pages = "1553--1557",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Modern management of laryngotracheal stenosis

AU - Herrington, Heather C.

AU - Weber, Stephen M.

AU - Andersen, Peter

PY - 2006/9

Y1 - 2006/9

N2 - OBJECTIVES: Laryngotracheal stenosis is a complex problem resulting most often from intubation, trauma,or autoimmune disease. Management options include dilation or airway reconstruction including laryngotracheoplasty (LTP), cricotracheal resection (CTR), and tracheal resection (TR). We describe our experience with management of this difficult problem. STUDY DESIGN: Retrospective chart review of patients treated for laryngotracheal stenosis between January 1995 and July 2005 at an academic, tertiary referral center. METHODS: A total of 127 patients were treated during the study period. Patients were followed, and hospital records were reviewed. RESULTS: There were 38 male and 89 female patients with an average age of 55.5 years treated for laryngotracheal stenosis resulting from intubation (64), idiopathic (25) or autoimmune disease (18), radiation (9), trauma (5), prior surgery (4), and relapsing polychondritis (2). Thirty-three percent were treated for grade I stenosis, 44% grade II, 19% grade III, and 4% grade IV. Seventy percent of patients undergoing initial dilation required a subsequent procedure. LTP, CTR, or TR was performed in 43%, 48%, 71%, and 100% of patients with grade I through IV stenosis, respectively. Among 76 patients undergoing LTP, CTR, or TR, 24 (32%) required a subsequent intervention. Among 36 patients treated with primary LTP, CTR, or TR, only 10 (28%) required further therapy. Twenty-two of 35 (63%) tracheostomy-dependent patients were ultimately decannulated. Three patients died in the immediate postoperative period. CONCLUSIONS: Patients undergoing dilation for laryngotracheal stenosis require multiple procedures. However, major reconstructive procedures are well tolerated and currently represent a viable primary treatment for laryngotracheal stenosis.

AB - OBJECTIVES: Laryngotracheal stenosis is a complex problem resulting most often from intubation, trauma,or autoimmune disease. Management options include dilation or airway reconstruction including laryngotracheoplasty (LTP), cricotracheal resection (CTR), and tracheal resection (TR). We describe our experience with management of this difficult problem. STUDY DESIGN: Retrospective chart review of patients treated for laryngotracheal stenosis between January 1995 and July 2005 at an academic, tertiary referral center. METHODS: A total of 127 patients were treated during the study period. Patients were followed, and hospital records were reviewed. RESULTS: There were 38 male and 89 female patients with an average age of 55.5 years treated for laryngotracheal stenosis resulting from intubation (64), idiopathic (25) or autoimmune disease (18), radiation (9), trauma (5), prior surgery (4), and relapsing polychondritis (2). Thirty-three percent were treated for grade I stenosis, 44% grade II, 19% grade III, and 4% grade IV. Seventy percent of patients undergoing initial dilation required a subsequent procedure. LTP, CTR, or TR was performed in 43%, 48%, 71%, and 100% of patients with grade I through IV stenosis, respectively. Among 76 patients undergoing LTP, CTR, or TR, 24 (32%) required a subsequent intervention. Among 36 patients treated with primary LTP, CTR, or TR, only 10 (28%) required further therapy. Twenty-two of 35 (63%) tracheostomy-dependent patients were ultimately decannulated. Three patients died in the immediate postoperative period. CONCLUSIONS: Patients undergoing dilation for laryngotracheal stenosis require multiple procedures. However, major reconstructive procedures are well tolerated and currently represent a viable primary treatment for laryngotracheal stenosis.

KW - Airway

KW - Cricotracheal resection

KW - Dilation

KW - Intubation

KW - Laryngotracheal stenosis

KW - Laryngotracheoplasty

KW - Tracheal resection

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=33748558123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748558123&partnerID=8YFLogxK

U2 - 10.1097/01.mlg.0000228006.21941.12

DO - 10.1097/01.mlg.0000228006.21941.12

M3 - Article

C2 - 16954977

AN - SCOPUS:33748558123

VL - 116

SP - 1553

EP - 1557

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 9

ER -