Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis

This article reports six patients with severe laryngotracheal stenosis. The causes of stenosis were tracheotomy (two cases); prolonged endotracheal in tubation (one case); laryngeal trauma (two cases); and surgery with postope rative chemo- and radiotherapy, addressing a thyroid gland follicular adeno carcinoma (one case). Two patients were already tracheotomized. The main po stoperative complication was necrosis of the graft in a female patient who had previously undergone treatment for thyroid follicular adenocarcinoma. A ll patients were decannulated 6 months postoperatively. Five patients were then regularly followed up, but we lost contact with one patient. Compariso n between pre- and postoperative pulmonary function testing revealed an inc reased maximum inspiratory flow (V(i)max(50)) in five cases between 0.57 l/ s and 2.18 l/s. A helical scan with 3-dimensional reconstruction of the cer vical area in four patients confirmed the presence and preservation of the hyoid bone graft. Four patients remained satisfied with their postoperative voice quality, one patient was dissatisfied, and one patient was not follo wed up. This technique is effective in adults with severe laryngotracheal s tenosis, restricted to the first tracheal rings, providing one takes into c onsideration the main contraindications of the procedure: past history of r adiotherapy and thyroid surgery.