Reconstructive Surgery of Stenosis of the Respiratory Tract Performed in Two Cases

Abstract

The author reported two cases of airway strictures which have been successfully reconstructed in the past four years. In both cases respiratory tracts were injured by traffic accidents.
Case 1 was a 47-year-old male. The anterior portion of his neck was severely damaged by a frontal clash between cars. Consequently his thyroid cartilage was fractured and the displacement of cartilage fragment induced a stricture of glottis. An incision was made in the midline of the thyroid cartilage. The fracture of the thyroid cartilage was reduced. Silicone T-tube was inserted into glottis and was fixed. Finally the thyroid cartilage was sutured with silver wires. Approximately three months after the operation, the airway improved without any difficulty in breathing or swallowing. There was a hoarseness. However, he has been back to his job.
Case 2 was a 7-year-old boy. He sustained a head trauma by a car accident and was urgently hospitalized in the Neurosurgery unit. Emergency tracheotomy was performed. Decannulation was failed due to excessively proliferated granuloma around the tracheostoma. Therefore, the tracheal granuloma was entirely removed under general anesthesia. Approximately 1.5cm of the skin around the lesion was resected. A suture between the trachea and the insiced skin was tightly performed, and then silicone cuffs button-type cannula was inserted. Approximately eight months after the operation, the airway improved and cannula was removed. Only a small fistula of about 2mm in diameter is present in the operated area with cicatricial healing. The patient has been back to school again without any troubles.