Surgical Treatments for Airway Stenosis in Adults

Abstract

Laryngotracheal stenosis (LTS) is narrowing of the upper airway between the larynx and trachea. Adult LTS is acquired and has various etiologies, including tracheal intubation, tracheostomy, trauma, autoimmune disease, infection and idiopathic. The majority of LTS cases are subglottic stenosis (SGS). Treatment options for SGS include transoral (endoscopic) surgery and open surgery. Transoral surgery is performed on patients with mild SGS, such as grade 1 or 2 SGS with a normal glottis. Balloon dilation laryngoplasty is an efficient and safe technique and is becoming more and more popular. Open surgery is performed on patients with severe SGS, such as grade 3 or 4. This approach includes laryngotracheal reconstruction (LTR), the trough method and cricotracheal resection (CTR). LTR is a surgery to widen the subglottis and trachea by inserting a small piece of cartilage. The trough method is a surgery to reconstruct the anterior wall of the cricoid and trachea with a skin flap and cartilage graft in the second stage. CTR is a surgery to remove the anterior cricoid ring and trachea and to anastmose resection stumps.