Laryngotracheal reconstruction in subglottic stenosis: An ancient problem still present

BACKGROUND: Subglottic stenosis is an ancient but persistent problem as a c ause of airway obstruction. The etiology and the results of surgical treatm ent with thyrotracheal anastomosis were reviewed. METHODS: Fifty-six patients with subglottic stenosis were studied. All were subjected to laryngotracheal reconstruction by thyrotracheal anastomosis w ith partial resection of the cricoid. RESULTS. Of all 56 cases of subglottic stenosis, 48 (86%) had history of pr evious tracheal intubation, and only 8 (14%) had different non-neoplastic o bstructive processes such as scleroma, direct injury, hamartoma, and amyloi dosis. Immediate results were good in all cases. After I year followup, res ults of thyrotracheal anastomosis were successful in 44 (91%). In 4 other c ases a restenosis was observed. Eight patients were lost to follow-up. CONCLUSIONS: Subglottic stenosis is still frequent after tracheal intubatio n, but other causes must be considered. Laryngotracheal reconstruction with thyrotracheal anastomosis with partial cricoid resection was feasible with good results in 91% of the cases with follow-up, but this procedure must b e performed by a skilled surgical team.