Abstract
Recently, the incidence of subglottic stenosis has increased following prolonged endotracheal intubation for respiratory support, or secondary to blunt injury and malignant neoplasm. We described our surgical procedures for treating subglottic stenosis. In cases without injury or deformity of the cricoid cartilage, a laryngofissure is performed with the removal of scar tissue in the stenosis and the oral mucosa graft sutured to the defect. About 2 to 3 weeks after such an operation, the anterior wall is covered by a hinge flap.
In cases with recurrent laryngeal nerve paralysis, partial cricoid resection including the crico-thyroid joint, has been possible. After the recurrent laryngeal nerve was identified on the opposite side, a primary anastomosis was performed between the distal trachea and the residual cricoid cartilage.
In cases without recurrent laryngeal nerve paralysis, half of all cricoid resections were performed with the preserved recurrent laryngeal nerve, and then the lateral wall of the cricoid was made of an advancement flap. Secondary reconstruction of the anterior wall was performed with a hinge flap and an advancement flap.
Surgical procedures for subglottic stenosis are considered based on the type of the stenosis, its degree, and its association with recurrent laryngeal nerve paralysis.
