Subglottic and tracheal stenosis

Abstract

Train yourself adequately in laryngotracheal surgery and upper airway endoscopy before address-ing the challenging surgery of laryngotracheal stenosis (LTS). Remember that inappropriate initial management of LTS may lead to permanent intractable sequelae and that the best chance for the patient lies in the first operation. Perform a thorough preoperative assessment of the patient's medical condition and of the stenosis to choose the best surgical option and timing. Address only mature cicatricial stenosis for a definitive endoscopic or open surgical repair. Perform a bacteriologic aspirate of the trachea prior to any treatment. Treat gastro-oesophageal reflux. Master all types of surgeries starting from appropriate use of CO2 laser for minor stenosis to laryngotracheal reconstruction with cartilage expansion and partial cricotracheal resection for the most severe grades of stenosis. © Springer-Verlag Berlin Heidelberg 2010.