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

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. A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive...

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Bibliographic Details
Published in:Journal of laryngology and otology 2017-05, Vol.131 (5), p.447-454
Main Authors: Gozen, E D, Yener, M, Erdur, Z B, Karaman, E
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Airway management
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - methods
Child
Child, Preschool
Cricoid Cartilage - surgery
Dyspnea
Female
General anesthesia
Granulation Tissue
Humans
Intubation
Laryngostenosis - etiology
Laryngostenosis - surgery
Larynx - surgery
Lasers
Main Articles
Male
Middle Aged
Ostomy
Otolaryngology
Postoperative Complications - etiology
Retrospective Studies
Subcutaneous Emphysema - etiology
Surgery
Thyroid gland
Thyroid Neoplasms - pathology
Thyroid Neoplasms - surgery
Thyroidectomy - adverse effects
Trachea - surgery
Tracheal Stenosis - etiology
Tracheal Stenosis - surgery
Tracheotomy
Tracheotomy - adverse effects
Tracheotomy - methods
Treatment Outcome
Vocal Cord Paralysis - etiology
Young Adult
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Summary: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. 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. 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). 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.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215117000378