MANAGEMENT OF LARYNGOTRACHEAL STENOSIS ON THE BASIS OF SITE AND SEVERITY

Seventy-five cases of laryngotracheal stenosis treated between 1981 an d 1991 were reviewed to determine the effectiveness of surgical treatm ent on the basis of site and severity of stenosis. Decannulation and a bsence of exertional dyspnea were the criteria of successful managemen t. The treatment methods used were endoscopic laser incision and dilat ation, expansion laryngotracheoplasty, and segmental resection. Endosc opic procedures were effective in treating thin (<1 cm) stenoses in th e subglottis and trachea. Laryngotracheoplasty was most effective in t reating thick stenoses of the glottis and subglottis. Tracheal stenose s were most effectively treated by segmental resections. The probabili ty for decannulation decreased with longer narrower stenoses and with increasing clinical stage.